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psnet.ahrq.gov/node/837640/psn-pdf
July 06, 2022 - Identifying and reconciling patients' allergy information
within the electronic health record.
July 6, 2022
Vallamkonda S, Ortega CA, Lo YC, et al. Identifying and reconciling patients' allergy information within the
electronic health record. Stud Health Technol Inform. 2022;290:120-124. doi:10.3233/shti220044.
ht…
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psnet.ahrq.gov/node/836954/psn-pdf
April 20, 2022 - Effects of tall man lettering on the visual behaviour of
critical care nurses while identifying syringe drug labels:
a randomised in situ simulation.
April 20, 2022
Lohmeyer Q, Schiess C, Wendel Garcia PD, et al. Effects of tall man lettering on the visual behaviour of
critical care nurses while identifying syring…
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psnet.ahrq.gov/node/46541/psn-pdf
January 31, 2018 - The 2017 ACGME common work hour standards:
promoting physician learning and professional
development in a safe, humane environment.
January 31, 2018
Burchiel KJ, Zetterman RK, Ludmerer KM, et al. The 2017 ACGME Common Work Hour Standards:
Promoting Physician Learning and Professional Development in a Safe, Humane …
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psnet.ahrq.gov/node/866076/psn-pdf
June 05, 2024 - Locum doctor working and quality and safety: a
qualitative study in English primary and secondary care.
June 5, 2024
Ferguson J, Stringer G, Walshe K, et al. Locum doctor working and quality and safety: a qualitative study in
English primary and secondary care. BMJ Qual Saf. 2024;33(6):354-362. doi:10.1136/bmjqs-20…
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psnet.ahrq.gov/node/72820/psn-pdf
March 10, 2021 - Medication errors related to computerized provider order
entry systems in hospitals and how they change over
time: a narrative review.
March 10, 2021
Kinlay M, Zheng WY, Burke R, et al. Medication errors related to computerized provider order entry
systems in hospitals and how they change over time: A narrative re…
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psnet.ahrq.gov/node/44508/psn-pdf
November 20, 2015 - Outcomes associated with the nationwide introduction of
rapid response systems in the Netherlands.
November 20, 2015
Ludikhuize J, Brunsveld-Reinders AH, Dijkgraaf MGW, et al. Outcomes Associated With the Nationwide
Introduction of Rapid Response Systems in The Netherlands. Crit Care Med. 2015;43(12):2544-51.
doi:…
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psnet.ahrq.gov/node/35407/psn-pdf
September 11, 2009 - Liability reform should make patients safer: "Avoidable
classes of events" are a key improvement.
September 11, 2009
Bovbjerg RR, Tancredi LR. Liability reform should make patients safer: "avoidable classes of events" are a
key improvement. J Law Med Ethics. 2005;33(3):478-500.
https://psnet.ahrq.gov/issue/liabili…
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psnet.ahrq.gov/node/73350/psn-pdf
June 02, 2021 - Learning during crisis: the impact of COVID-19 on
hospital-acquired pressure injury incidence.
June 2, 2021
Polancich S, Hall AG, Miltner RS, et al. Learning during crisis: the impact of COVID-19 on hospital-acquired
pressure injury incidence. J Healthc Qual. 2021;43(3):137-144. doi:10.1097/jhq.0000000000000301.
h…
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psnet.ahrq.gov/node/72706/psn-pdf
February 03, 2021 - Impact of alarm fatigue on the work of nurses in an
intensive care environment--a systematic review.
February 3, 2021
Lewandowska K, Weisbrot M, Cieloszyk A, et al. Impact of alarm fatigue on the work of nurses in an
intensive care environment--a systematic review. Int J Environ Res Public Health. 2020;17(22):8409.…
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psnet.ahrq.gov/node/854995/psn-pdf
November 01, 2023 - Intervention of pharmacist included in multidisciplinary
team to reduce adverse drug event: a qualitative
systematic review.
November 1, 2023
Zaij S, Pereira Maia K, Leguelinel-Blache G, et al. Intervention of pharmacist included in multidisciplinary
team to reduce adverse drug event: a qualitative systematic revi…
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psnet.ahrq.gov/node/43444/psn-pdf
August 27, 2014 - Patient-safety–related hospital deaths in England:
thematic analysis of incidents reported to a national
database, 2010–2012.
August 27, 2014
Donaldson LJ, Panesar S, Darzi A. Patient-safety-related hospital deaths in England: thematic analysis of
incidents reported to a national database, 2010-2012. PLoS Med. 201…
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psnet.ahrq.gov/node/46598/psn-pdf
March 20, 2018 - Fatigue risk management: the impact of anesthesiology
residents' work schedules on job performance and a
review of potential countermeasures.
March 20, 2018
Wong LR, Flynn-Evans E, Ruskin KJ. Fatigue Risk Management: The Impact of Anesthesiology Residents'
Work Schedules on Job Performance and a Review of Potentia…
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psnet.ahrq.gov/issue/communication-and-resolution-programs-emerging-best-practice-addressing-patient-harm
July 29, 2020 - Upcoming Meeting/Conference
Communication and Resolution Programs: An Emerging Best Practice for Addressing Patient Harm.
Citation Text:
National Association for Healthcare Quality. August 26, 2021, 1:00–2:00 PM (eastern).
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psnet.ahrq.gov/issue/reporting-patient-safety-events-challenge
April 25, 2012 - Award
Award Recipient
Published April 25, 2012
Reporting Patient Safety Events Challenge.
Topics
Approach to Improving Safety
Institutional Reporting
Clinical Information Systems
R…
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psnet.ahrq.gov/node/42789/psn-pdf
December 04, 2013 - Development of the just culture assessment tool:
measuring the perceptions of health-care professionals in
hospitals.
December 4, 2013
Petschonek S, Burlison JD, Cross C, et al. Development of the just culture assessment tool: measuring the
perceptions of health-care professionals in hospitals. J Patient Saf. 2013…
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psnet.ahrq.gov/node/43782/psn-pdf
September 28, 2016 - The use of technology for urgent clinician to clinician
communications: a systematic review of the literature.
September 28, 2016
Nguyen C, McElroy LM, Abecassis MM, et al. The use of technology for urgent clinician to clinician
communications: a systematic review of the literature. Int J Med Inform. 2015;84(2):101…
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psnet.ahrq.gov/node/38295/psn-pdf
May 27, 2010 - Narrative review: do state laws make it easier to say "I'm
sorry"?
May 27, 2010
McDonnell WM, Guenther E. Narrative review: do state laws make it easier to say "I'm sorry?". Ann Intern
Med. 2008;149(11):811-816.
https://psnet.ahrq.gov/issue/narrative-review-do-state-laws-make-it-easier-say-im-sorry
Multiple studi…
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psnet.ahrq.gov/node/38608/psn-pdf
January 02, 2017 - Using consumer-based kiosk technology to improve and
standardize medication reconciliation in a specialty care
setting.
January 2, 2017
Lesselroth B, Adams S, Felder R, et al. Using consumer-based kiosk technology to improve and
standardize medication reconciliation in a specialty care setting. Jt Comm J Qual Pati…
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psnet.ahrq.gov/node/866587/psn-pdf
January 01, 2025 - Professionalising patient safety? Findings from a mixed-
methods formative evaluation of the patient safety
specialist role in the English National Health Service.
August 28, 2024
Martin G, Pralat R, Waring J, et al. Professionalising patient safety? Findings from a mixed-methods
formative evaluation of the patien…
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psnet.ahrq.gov/node/41732/psn-pdf
October 03, 2012 - Double checking the administration of medicines: what is
the evidence? A systematic review.
October 3, 2012
Alsulami Z, Conroy S, Choonara I. Double checking the administration of medicines: what is the evidence?
A systematic review. Arch Dis Child. 2012;97(9):833-7. doi:10.1136/archdischild-2011-301093.
https://p…