-
psnet.ahrq.gov/node/46920/psn-pdf
August 08, 2018 - Identification and characterization of failures in infectious
agent transmission precaution practices in hospitals: a
qualitative study.
August 8, 2018
Krein SL, Mayer J, Harrod M, et al. Identification and Characterization of Failures in Infectious Agent
Transmission Precaution Practices in Hospitals: A Qualitati…
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psnet.ahrq.gov/node/39264/psn-pdf
February 03, 2010 - Changing cardiac arrest and hospital mortality rates
through a medical emergency team takes time and
constant review.
February 3, 2010
Santamaria J, Tobin A, Holmes J. Changing cardiac arrest and hospital mortality rates through a medical
emergency team takes time and constant review. Crit Care Med. 2010;38(2):445…
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psnet.ahrq.gov/node/837418/psn-pdf
June 15, 2022 - Diagnostic trajectories in primary care at 12 months: an
observational cohort study.
June 15, 2022
Fontil V, Khoong EC, Lyles C, et al. Diagnostic trajectories in primary care at 12 months: an observational
cohort study. Jt Comm J Qual Patient Saf. 2022;48(8):395-402. doi:10.1016/j.jcjq.2022.04.010.
https://psnet.…
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psnet.ahrq.gov/node/47278/psn-pdf
August 15, 2018 - Drawing boundaries: the difficulty in defining clinical
reasoning.
August 15, 2018
Young M, Thomas A, Lubarsky S, et al. Drawing Boundaries: The Difficulty in Defining Clinical Reasoning.
Acad Med. 2018;93(7):990-995. doi:10.1097/ACM.0000000000002142.
https://psnet.ahrq.gov/issue/drawing-boundaries-difficulty-defi…
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psnet.ahrq.gov/node/47099/psn-pdf
May 16, 2018 - Defense Health Agency Should Improve Tracking of
Serious Adverse Medical Events and Monitoring of
Required Follow-up.
May 16, 2018
Washington, DC: United States Government Accountability Office; April 2018. Publication GAO-18-378.
https://psnet.ahrq.gov/issue/defense-health-agency-should-improve-tracking-serious-a…
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psnet.ahrq.gov/node/44498/psn-pdf
December 04, 2016 - State-mandated hospital infection reporting is not
associated with decreased pediatric health
care–associated infections.
December 4, 2016
Rinke ML, Bundy DG, Abdullah F, et al. State-Mandated Hospital Infection Reporting Is Not Associated
With Decreased Pediatric Health Care-Associated Infections. J Patient Saf. …
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psnet.ahrq.gov/node/45823/psn-pdf
May 09, 2017 - The effect of prescriber education on medication-related
patient harm in the hospital: a systematic review.
May 9, 2017
Bos JM, van den Bemt PMLA, de Smet PAGM, et al. The effect of prescriber education on medication-
related patient harm in the hospital: a systematic review. Br J Clin Pharmacol. 2017;83(5):953-961…
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psnet.ahrq.gov/node/44968/psn-pdf
January 23, 2017 - Financial incentives and mortality: taking pay for
performance a step too far.
January 23, 2017
Gupta K, Wachter R, Kachalia A. Financial incentives and mortality: taking pay for performance a step too
far. BMJ Qual Saf. 2017;26(2):164-168. doi:10.1136/bmjqs-2015-004835.
https://psnet.ahrq.gov/issue/financial-ince…
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psnet.ahrq.gov/node/44282/psn-pdf
June 12, 2018 - Standardized competencies for parenteral nutrition
prescribing: The American Society for Parenteral and
Enteral Nutrition Model.
June 12, 2018
Guenter P, Boullata JI, Ayers P, et al. Standardized Competencies for Parenteral Nutrition Prescribing: The
American Society for Parenteral and Enteral Nutrition Model. Nut…
-
psnet.ahrq.gov/node/45138/psn-pdf
May 25, 2016 - Improving Weekend Out Of Hours Surgical Handover
(WOOSH).
May 25, 2016
Boyer M, Tappenden J, Peter M. Improving Weekend Out Of hours Surgical Handover (WOOSH). BMJ
Qual Improv Rep. 2016;5(1):1-4. doi:10.1136/bmjquality.u209552.w4190.
https://psnet.ahrq.gov/issue/improving-weekend-out-hours-surgical-handover-woosh
…
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psnet.ahrq.gov/node/44780/psn-pdf
May 09, 2017 - Improving anesthesiologists' ability to speak up in the
operating room: a randomized controlled experiment of a
simulation-based intervention and a qualitative analysis
of hurdles and enablers.
May 9, 2017
Raemer DB, Kolbe M, Minehart RD, et al. Improving Anesthesiologists’ Ability to Speak Up in the Operating
Ro…
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psnet.ahrq.gov/node/46933/psn-pdf
April 04, 2018 - Pain states, the opioid epidemic, and the role of
radiologists.
April 4, 2018
Jones MR, Kaye AD, Manchikanti L, et al. Pain States, the Opioid Epidemic, and the Role of Radiologists.
Curr Pain Headache Rep. 2018;22(3):20. doi:10.1007/s11916-018-0672-x.
https://psnet.ahrq.gov/issue/pain-states-opioid-epidemic-and-r…
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psnet.ahrq.gov/node/838930/psn-pdf
October 26, 2022 - Artificial Intelligence in Health Care: Benefits and
Challenges of Machine Learning Technologies for Medical
Diagnostics.
October 26, 2022
Washington DC: United States Government Accountability Office and National Academy of
Medicine; September 2022. Report no. GAO-22-104629.
https://psnet.ahrq.gov/issue/ar…
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psnet.ahrq.gov/node/38993/psn-pdf
January 04, 2010 - Relationship between call light use and response time
and inpatient falls in acute care settings.
January 4, 2010
Tzeng H-M, Yin C-Y. Relationship between call light use and response time and inpatient falls in acute care
settings. J Clin Nurs. 2009;18(23):3333-41. doi:10.1111/j.1365-2702.2009.02916.x.
https://psn…
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psnet.ahrq.gov/node/47574/psn-pdf
November 21, 2018 - The architecture of safety: an emerging priority for
improving patient safety.
November 21, 2018
Joseph A, Henriksen K, Malone E. The Architecture Of Safety: An Emerging Priority For Improving Patient
Safety. Health Aff (Millwood). 2018;37(11):1884-1891. doi:10.1377/hlthaff.2018.0643.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/35159/psn-pdf
January 02, 2017 - Medication reconciliation in acute care: ensuring an
accurate drug regimen on admission and discharge.
January 2, 2017
Rodehaver C, Fearing D. Medication reconciliation in acute care: ensuring an accurate drug regimen on
admission and discharge. Jt Comm J Qual Patient Saf. 2005;31(7):406-13.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/47068/psn-pdf
June 25, 2018 - The need for closed-loop systems for management of
abnormal test results.
June 25, 2018
Zuccotti G, Samal L, Maloney FL, et al. The Need for Closed-Loop Systems for Management of Abnormal
Test Results. Ann Intern Med. 2018;168(11):820-821. doi:10.7326/M17-2425.
https://psnet.ahrq.gov/issue/need-closed-loop-systems…
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psnet.ahrq.gov/node/46176/psn-pdf
October 04, 2017 - Incidence and severity of prescribing errors in parenteral
nutrition for pediatric inpatients at a neonatal and
pediatric intensive care unit.
October 4, 2017
Hermanspann T, Schoberer M, Robel-Tillig E, et al. Incidence and Severity of Prescribing Errors in
Parenteral Nutrition for Pediatric Inpatients at a Neonat…
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psnet.ahrq.gov/node/838315/psn-pdf
October 12, 2022 - Contributors to diagnostic error or delay in the acute care
setting: a survey of clinical stakeholders.
October 12, 2022
Redmond S, Barwise A, Zornes S, et al. Contributors to diagnostic error or delay in the acute care setting:
a survey of clinical stakeholders. Health Serv Insights. 2022;15:117863292211235.
doi:…
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psnet.ahrq.gov/node/60753/psn-pdf
August 05, 2020 - A qualitative exploration of mental health service user
and carer perspectives on safety issues in UK mental
health services.
August 5, 2020
Berzins K, Baker J, Louch G, et al. A qualitative exploration of mental health service user and carer
perspectives on safety issues in UK mental health services. Health Expec…