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381. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/853773/psn-pdf
     September 27, 2023 - psnet.ahrq.gov/web-mm/double-never-event-wrong-patient-and-wrong-side The Case A first-year orthopedic surgery … ucdavis.edu Edgardo S Salcedo, MD, FACS Professor Interim Vice Chair of Education Program Director, General … Surgery Residency Program Director, Surgical Education and Simulation Fellowship Department of Surgery … Avoidance of serious medical errors in refractive surgery using a custom preoperative checklist. … A literature review exploring common factors contributing to Never Events in surgery.

382. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/846759/psn-pdf
     March 29, 2023 - A contemporary analysis of closed claims related to wrong site surgery. … A contemporary analysis of closed claims related to wrong site surgery. … https://psnet.ahrq.gov/issue/contemporary-analysis-closed-claims-related-wrong-site-surgery Wrong-site … surgery is considered a never event and can lead to serious patient harm. … that the risk of wrong-site surgery increases with spinal surgeries (e.g., spinal fusion, excision

383. Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture. | PSNet
     psnet.ahrq.gov/issue/association-between-implementing-comprehensive-learning-collaborative-strategies-statewide
     September 02, 2020 - Resources From the Same Author(s) A national mixed-methods evaluation of preparedness for general … surgery residency and the association with resident burnout. … September 9, 2020 Quality and safety in surgery: challenges and opportunities. … Continuous monitoring of adverse events: influence on the quality of care and the incidence of errors in general … surgery.

384. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/46853/psn-pdf
     February 22, 2019 - Outcomes with overlapping surgery at a large academic medical center. … Outcomes With Overlapping Surgery at a Large Academic Medical Center. … https://psnet.ahrq.gov/issue/outcomes-overlapping-surgery-large-academic-medical-center The practice … of overlapping surgery has raised significant concerns about patient safety. … /issue/safety-overlapping-surgery-high-volume-referral-center https://psnet.ahrq.gov/issue/association-overlapping-surgery-increased-risk-complications-following-hip-surgery

385. When the bone flap hits the floor. | PSNet
     psnet.ahrq.gov/issue/when-bone-flap-hits-floor
     March 12, 2025 - April 24, 2018 Readiness of US general surgery residents for independent practice. … April 2, 2014 Application of surgical safety standards to robotic surgery: five principles … November 14, 2012 Surgical site infections in colon surgery: the patient, the procedure

386. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/848363/psn-pdf
     May 03, 2023 - Impact of the percentage of overlapping surgery on patient outcomes: a retrospective cohort study of … Impact of the percentage of overlapping surgery on patient outcomes: a retrospective cohort study of … https://psnet.ahrq.gov/issue/impact-percentage-overlapping-surgery-patient-outcomes-retrospective-cohort … - study-87000 Overlapping surgery – when surgeons schedule distinct procedures on different patients … concurrent-and-overlapping-surgeries-additional-measures-warranted https://psnet.ahrq.gov/issue/association-overlapping-surgery-increased-risk-complications-following-hip-surgery

387. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47714/psn-pdf
     March 27, 2019 - Quality improvement in ambulatory surgery centers: a major national effort aimed at reducing infections … Quality Improvement in Ambulatory Surgery Centers: A Major National Effort Aimed at Reducing Infections … https://psnet.ahrq.gov/issue/quality-improvement-ambulatory-surgery-centers-major-national-effort-aimed … - reducing Ambulatory surgery centers are increasingly utilized to provide surgical care to patients … They identified several barriers and conclude that the unique aspects of ambulatory surgery centers

388. Perioperative patient safety recommendations: systematic review of clinical practice guidelines. | PSNet
     psnet.ahrq.gov/issue/perioperative-patient-safety-recommendations-systematic-review-clinical-practice-guidelines
     January 08, 2025 - 2025 Predictive power of the "trigger tool" for the detection of adverse events in general … surgery: a multicenter observational validation study. … September 14, 2022 Crisis recovery in surgery: error management and problem solving in … November 17, 2021 View More See More About The Topic Outpatient Surgery … Operating Room Anesthesiology Surgery Medical/Surgical Nursing View More

389. Moving towards a core measures set for patient safety in perioperative care: an e-Delphi consensus study. | PSNet
     psnet.ahrq.gov/issue/moving-towards-core-measures-set-patient-safety-perioperative-care-e-delphi-consensus-study
     January 15, 2025 - 2025 Predictive power of the "trigger tool" for the detection of adverse events in general … surgery: a multicenter observational validation study. … March 8, 2023 Crisis recovery in surgery: error management and problem solving in safety-critical … November 17, 2021 View More See More About The Topic Outpatient Surgery … Operating Room Anesthesiology Surgery Medical/Surgical Nursing View More

390. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/72590/psn-pdf
     December 23, 2020 - Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study. … Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study. … https://psnet.ahrq.gov/issue/effects-night-surgery-postoperative-mortality-and-morbidity-multicentre-cohort … This retrospective cohort study including over 350,000 adult patients undergoing non- cardiac surgery … found that night surgery was associated with an increased risk of postoperative mortality and morbidity

391. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47717/psn-pdf
     June 27, 2019 - Does overlapping surgery result in worse surgical outcomes? … Does overlapping surgery result in worse surgical outcomes? A systematic review and meta-analysis. … https://psnet.ahrq.gov/issue/does-overlapping-surgery-result-worse-surgical-outcomes-systematic-review … - and-meta-analysis This systematic review of the safety of overlapping surgery included 14 studies … They conclude that overlapping surgery does not lead to higher risk for morbidity and mortality, despite

392. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47826/psn-pdf
     March 27, 2019 - Office-based surgery and patient outcomes. March 27, 2019 Young S, Shapiro FE, Urman RD. … Office-based surgery and patient outcomes. … https://psnet.ahrq.gov/issue/office-based-surgery-and-patient-outcomes Office-based surgery is increasingly … This review summarizes the literature on ambulatory surgery outcomes and identified risk factors such … https://psnet.ahrq.gov/issue/office-based-surgery-and-patient-outcomes https://psnet.ahrq.gov/issue/lax-oversight-leaves-surgery-center-regulators-and-patients-dark

393. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/845361/psn-pdf
     March 29, 2023 - A standardized marking procedure for ENT operations to prevent wrong-site surgery: development, establishment … A standardized marking procedure for ENT operations to prevent wrong-site surgery: development, establishment … Despite being classified as a never event, wrong site surgery continues to be an issue in otolaryngology … In this study, researchers developed marking procedure for ENT surgery that accomplishes four objectives … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov

394. Adverse events in the operating room: definitions, prevalence, and characteristics. A systematic review. | PSNet
     psnet.ahrq.gov/issue/adverse-events-operating-room-definitions-prevalence-and-characteristics-systematic-review
     July 25, 2018 - March 19, 2019 Using data to enhance performance and improve quality and safety in surgery … November 6, 2019 Defining technical errors in laparoscopic surgery: a systematic review … October 9, 2013 A simple surgery with harrowing complications. … See More About The Topic Operating Room Health Care Executives and Administrators General … Surgery Intraoperative Complications Error Reporting

395. Some doctors questioning whether shorter shifts for interns are endangering patients. | PSNet
     psnet.ahrq.gov/issue/some-doctors-questioning-whether-shorter-shifts-interns-are-endangering-patients
     July 26, 2017 - May 28, 2014 Misdiagnosis is more common than drug errors or wrong-site surgery. … March 7, 2007 The pain of wrong site surgery. … Related Resources A systematic review of the effects of resident duty hour restrictions in surgery … December 12, 2012 Duty hours, quality of care, and patient safety: general surgery resident

396. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/48011/psn-pdf
     May 29, 2019 - Is it time for safeguards in the adoption of robotic surgery? May 29, 2019 Sheetz KH, Dimick JB. … Is It Time for Safeguards in the Adoption of Robotic Surgery? … A WebM&M commentary discussed an incident of harm associated with robotic-assisted surgery. … https://psnet.ahrq.gov/issue/it-time-safeguards-adoption-robotic-surgery https://psnet.ahrq.gov/issue … /web-mm/robotic-surgery-risks-vs-rewards

397. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47134/psn-pdf
     March 04, 2019 - Association of hydrocodone schedule change with opioid prescriptions following surgery. … Association of Hydrocodone Schedule Change With Opioid Prescriptions Following Surgery. … https://psnet.ahrq.gov/issue/association-hydrocodone-schedule-change-opioid-prescriptions-following- surgery … effect of the change on hydrocodone prescribing for patients in Michigan who had undergone elective surgery … https://psnet.ahrq.gov/issue/wide-variation-and-overprescription-opioids-after-elective-surgery https

398. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/73251/psn-pdf
     May 12, 2021 - Preventable morbidity and mortality among non-trauma emergency surgery patients: the role of personal … Preventable morbidity and mortality among non-trauma emergency surgery patients: the role of personal … https://psnet.ahrq.gov/issue/preventable-morbidity-and-mortality-among-non-trauma-emergency-surgery- … patients-role-personal The authors retrospectively reviewed records for 150 patients undergoing emergency surgery … https://psnet.ahrq.gov/issue/preventable-morbidity-and-mortality-among-non-trauma-emergency-surgery-patients-role-personal

399. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47951/psn-pdf
     April 24, 2019 - Safe medication management at ambulatory surgery centers. April 24, 2019 Ubaldi K. … Safe Medication Management at Ambulatory Surgery Centers. AORN J. 2019;109(4):435-442. … https://psnet.ahrq.gov/issue/safe-medication-management-ambulatory-surgery-centers Safe medication use … can be challenging in ambulatory surgery centers. … /issue/ambulatory-surgery-facilities-comprehensive-review-medication-error-reports-pennsylvania https

400. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/847735/psn-pdf
     May 30, 2023 - SOPS Ambulatory Surgery Center Survey: What You Need to Know. … https://psnet.ahrq.gov/issue/sops-ambulatory-surgery-center-survey-what-you-need-know Ambulatory surgery … This webcast provided information on AHRQ’s Surveys on Patient Safety Culture™ (SOPS®) Ambulatory Surgery … https://psnet.ahrq.gov/issue/sops-ambulatory-surgery-center-survey-what-you-need-know https://psnet.ahrq.gov … /issue/leading-causes-anesthesia-related-liability-claims-ambulatory-surgery-centers https://psnet.ahrq.gov