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psnet.ahrq.gov/issue/using-simulation-prepare-nursing-staff-move-new-building
January 15, 2014 - Commentary
Using simulation to prepare nursing staff for the move to a new building.
Citation Text:
Knippa S, Senecal P-A. Using Simulation to Prepare Nursing Staff for the Move to a New Building. J Nurses Prof Dev. 2017;33(2):E1-E5. doi:10.1097/NND.0000000000000329.
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psnet.ahrq.gov/issue/swiss-cheese-model-adverse-event-occurrence-closing-holes
September 25, 2024 - Commentary
The Swiss cheese model of adverse event occurrence—closing the holes.
Citation Text:
Stein JE, Heiss K. The Swiss cheese model of adverse event occurrence--Closing the holes. Semin Pediatr Surg. 2015;24(6):278-82. doi:10.1053/j.sempedsurg.2015.08.003.
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psnet.ahrq.gov/issue/medical-errors-neurosurgery
February 14, 2018 - Review
Medical errors in neurosurgery.
Citation Text:
Rolston JD, Zygourakis CC, Han SJ, et al. Medical errors in neurosurgery. Surg Neurol Int. 2014;5(Suppl 10):S435-40. doi:10.4103/2152-7806.142777.
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psnet.ahrq.gov/issue/surgical-procedure-grid-safety-and-operating-room-communication-multisite-surgery
June 17, 2014 - Commentary
A surgical procedure grid for safety and operating room communication in multisite surgery.
Citation Text:
Insalaco LF, Spiegel JH. A Surgical Procedure Grid for Safety and Operating Room Communication in Multisite Surgery. JAMA Facial Plast Surg. 2018;20(3):185-186. doi:10.10…
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psnet.ahrq.gov/issue/inside-closed-loop-medication-strategy-medication-management-targets-stages-which-errors
January 30, 2013 - Study
Inside a closed-loop medication strategy: medication management targets stages in which errors occur, step by step.
Citation Text:
Williams CT. Inside a closed-loop medication strategy. Nurs Manag. 2004;35 Suppl 5:8-9, 24.
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psnet.ahrq.gov/issue/effect-pharmacists-medication-errors-emergency-department
September 23, 2020 - Study
Effect of pharmacists on medication errors in an emergency department.
Citation Text:
Brown JN, Barnes CL, Beasley B, et al. Effect of pharmacists on medication errors in an emergency department. Am J Health Syst Pharm. 2008;65(4):330-3. doi:10.2146/ajhp070391.
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psnet.ahrq.gov/issue/support-and-recovery-strategies-second-victims
January 19, 2022 - Commentary
Support and recovery strategies for second victims.
Citation Text:
Croke L. Support and recovery strategies for second victims. AORN J. 2024;119(2):7-10. doi:10.1002/aorn.14089.
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psnet.ahrq.gov/issue/reducing-medication-errors-using-applied-technology
January 07, 2011 - Commentary
Reducing medication errors by using applied technology.
Citation Text:
Caesar BR, Hutchinson B. Reducing medication errors by using applied technology. Nursing (Brux). 2006;36(8):24-25.
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psnet.ahrq.gov/issue/fmea-team-performance-health-care-qualitative-analysis-team-member-perceptions
December 31, 2014 - Study
FMEA team performance in health care: a qualitative analysis of team member perceptions.
Citation Text:
Wetterneck TB, Hundt AS, Carayon P. FMEA Team Performance in Health Care. J Patient Saf. 2009;5(2). doi:10.1097/pts.0b013e3181a852be.
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psnet.ahrq.gov/issue/oncology-care-setting-design-and-planning-part-i-concepts-oncology-nurse-improve-patient
September 24, 2010 - Commentary
Oncology care setting design and planning part I: concepts for the oncology nurse that improve patient safety.
Citation Text:
Sheridan-Leos N. Oncology care setting design and planning part I: Concepts for the oncology nurse that improve patient safety. Clin J Oncol Nurs. 20…
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psnet.ahrq.gov/issue/next-phase-health-care-improvement-what-can-we-learn-social-movements
July 22, 2010 - Commentary
The next phase of health care improvement: what can we learn from social movements?
Citation Text:
Bate P, Robert G, Bevan H. The next phase of healthcare improvement: what can we learn from social movements? Qual Saf Health Care. 2004;13(1):62-6.
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psnet.ahrq.gov/issue/development-self-report-instrument-measure-patient-safety-attitudes-skills-and-knowledge
April 10, 2013 - Commentary
Development of a self-report instrument to measure patient safety attitudes, skills, and knowledge.
Citation Text:
Schnall R, Stone PW, Currie L, et al. Development of a self-report instrument to measure patient safety attitudes, skills, and knowledge. J Nurs Scholarsh. 2008…
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psnet.ahrq.gov/issue/clinical-supervisors-are-they-key-making-care-safer
June 26, 2019 - Commentary
Clinical supervisors: are they the key to making care safer?
Citation Text:
Walton M, Barraclough B. Clinical supervisors: are they the key to making care safer? BMJ Qual Saf. 2013;22(8):609-12. doi:10.1136/bmjqs-2012-001637.
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psnet.ahrq.gov/issue/medical-reconciliation-patients-discharged-emergency-department
March 04, 2015 - Study
Medical reconciliation in patients discharged from the emergency department.
Citation Text:
Sharma AN, Dvorkin R, Tucker V, et al. Medical reconciliation in patients discharged from the emergency department. J Emerg Med. 2012;43(2):366-73. doi:10.1016/j.jemermed.2011.05.080.
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psnet.ahrq.gov/issue/or-and-just-culture
February 01, 2017 - Commentary
The OR and a "just culture."
Citation Text:
Hamlin L. The OR and a "just culture". AORN J. 2009;90(4):495-498. doi:10.1016/j.aorn.2009.09.003.
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psnet.ahrq.gov/issue/management-reasoning-beyond-diagnosis
June 26, 2019 - Commentary
Management reasoning: beyond the diagnosis.
Citation Text:
Cook DA, Sherbino J, Durning SJ. Management Reasoning: Beyond the Diagnosis. JAMA. 2018;319(22):2267-2268. doi:10.1001/jama.2018.4385.
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psnet.ahrq.gov/issue/evolving-role-health-educators-advancing-patient-safety-forging-partnerships-and-leading
July 22, 2020 - Commentary
The evolving role of health educators in advancing patient safety: forging partnerships and leading change.
Citation Text:
Mercurio A. The evolving role of health educators in advancing patient safety: forging partnerships and leading change. Health Promot Pract. 2007;8(2):119…
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psnet.ahrq.gov/issue/effects-interdisciplinary-collaboration-hospitals-medication-errors-integrative-review
June 16, 2021 - Review
Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review.
Citation Text:
Manias E. Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert Opin Drug Saf. 2018;17(3):259-275. doi:10.1080/…
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psnet.ahrq.gov/issue/how-develop-effective-obstetric-checklist
November 16, 2022 - Review
How to develop an effective obstetric checklist.
Citation Text:
Fausett B, Propst A, Van Doren K, et al. How to develop an effective obstetric checklist. Am J Obstet Gynecol. 2011;205(3):165-70. doi:10.1016/j.ajog.2011.06.003.
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psnet.ahrq.gov/issue/structured-communication-patient-safety-emergency-medical-services-legal-case-report
November 21, 2021 - Commentary
Structured communication for patient safety in emergency medical services: a legal case report.
Citation Text:
Greenwood MJ, Heninger JR. Structured communication for patient safety in emergency medical services: a legal case report. Prehosp Emerg Care. 2010;14(3):345-8. doi…