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461. The Case of Mistaken Intubation | PSNet
     psnet.ahrq.gov/web-mm/case-mistaken-intubation
     July 01, 2016 - August 23, 2017 Medication errors in the care transition of trauma patients December … 2010 WebM&M Cases Recurrent Hypoglycemia: A Care Transition

462. Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. | PSNet
     psnet.ahrq.gov/issue/improving-patient-handoffs-and-transitions-through-adaptation-and-implementation-i-pass
     September 23, 2020 - Study Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Citation Text: Blazin LJ, Sitthi-Amorn J, Hoffman JM, et al. Improving patient handoffs and transitions through adaptation and implementation of I-PASS acros…

463. A Stable Airway? Fatal Airway Occlusion After Inadequate Post-Tracheostomy Care | PSNet
     psnet.ahrq.gov/web-mm/stable-airway-fatal-airway-occlusion-after-inadequate-post-tracheostomy-care
     June 28, 2023 - transitions of care between ICU and lower levels of care, and especially between institutions including transition

464. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/850343/psn-pdf
     December 12, 2023 - Challenge Competition: Impact of Patient Safety Tools. December 12, 2023 Rockville, MD: Agency for Healthcare Research and Quality; 2023. https://psnet.ahrq.gov/issue/challenge-competition-impact-patient-safety-tools The Agency for Healthcare Research and Quality (AHRQ) offers many practical tools and resource…

465. Pharmacist's Role in Medication Safety | PSNet
     psnet.ahrq.gov/primer/pharmacists-role-medication-safety
     March 14, 2018 - Pharmacist's Role in Medication Safety Citation Text: The Pharmacist's Role in Medication Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7…

466. Medication reconciliation meets its MATCH. | PSNet
     psnet.ahrq.gov/issue/medication-reconciliation-meets-its-match
     May 01, 2017 - Newspaper/Magazine Article Medication reconciliation meets its MATCH. Citation Text: Medication reconciliation meets its MATCH. Agency for Healthcare Research and Quality. Research Activities. May 2013:1, 3-4. Copy Citation Save Save to your library Print…

467. Addressing delays in medication administration for patients transferred from the hospital to the nursing home: a pilot quality improvement project. | PSNet
     psnet.ahrq.gov/issue/addressing-delays-medication-administration-patients-transferred-hospital-nursing-home-pilot
     November 16, 2022 - Study Addressing delays in medication administration for patients transferred from the hospital to the nursing home: a pilot quality improvement project. Citation Text: Ward KT, Bates-Jensen B, Eslami MS, et al. Addressing delays in medication administration for patients transferred …

468. Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study). | PSNet
     psnet.ahrq.gov/issue/impact-pharmacist-involvement-transitional-care-high-risk-patients-through-medication
     August 25, 2011 - Review Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study). Citation Text: Phatak A, Prusi R, Ward B, et al. Impact of pharmacist involvement in the transition…

469. Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. | PSNet
     psnet.ahrq.gov/issue/pharmacy-led-medication-reconciliation-programmes-hospital-transitions-systematic-review-and
     April 18, 2018 - Review Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. Citation Text: Mekonnen AB, McLachlan AJ, Brien J-AE. Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis.…

470. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/851189/psn-pdf
     July 05, 2023 - So many ways to be wrong: completeness and accuracy in a prospective study of OR-to-ICU handoff standardization. July 5, 2023 Conn Busch J, Wu J, Anglade E, et al. So many ways to be wrong: completeness and accuracy in a prospective study of OR-to-ICU handoff standardization. Jt Comm J Qual Patient Saf. 2023;49(8)…

471. Teamwork Training | PSNet
     psnet.ahrq.gov/primer/teamwork-training
     September 15, 2024 - Teamwork Training Citation Text: Teamwork Training. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Dow…

472. Artificial intelligence can be regulated using current patient safety procedures and infrastructure in hospitals. | PSNet
     psnet.ahrq.gov/issue/artificial-intelligence-can-be-regulated-using-current-patient-safety-procedures-and
     March 06, 2019 - Commentary Artificial intelligence can be regulated using current patient safety procedures and infrastructure in hospitals. Citation Text: Fleisher LA, Economou-Zavlanos NJ. Artificial intelligence can be regulated using current patient safety procedures and infrastructure in hospitals.…

473. I-PASS mentored implementation handoff curriculum: champion training materials. | PSNet
     psnet.ahrq.gov/issue/i-pass-mentored-implementation-handoff-curriculum-champion-training-materials
     November 16, 2022 - Commentary I-PASS mentored implementation handoff curriculum: champion training materials. Citation Text: O'Toole JK, Starmer AJ, Calaman S, et al. I-PASS Mentored Implementation Handoff Curriculum: Champion Training Materials. MedEdPORTAL. 2019;15:10794. doi:10.15766/mep_2374-8265.10794…

474. Disclosure of Medical Errors. | PSNet
     psnet.ahrq.gov/issue/disclosure-medical-errors
     September 17, 2018 - Organizational Policy/Guidelines Disclosure of Medical Errors. Citation Text: Disclosure of Medical Errors. Irving, TX: American College of Emergency Physicians; 2023. Copy Citation Save Save to your library Print Download PDF Share Faceboo…

475. Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study. | PSNet
     psnet.ahrq.gov/issue/effects-refined-evidence-based-toolkit-and-mentored-implementation-medication-reconciliation
     April 12, 2023 - Study Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study. Citation Text: Schnipper JL, Reyes Nieva H, Mallouk M, et al. Effects of a refined evidence-based toolkit and mentored implementation…

476. Advanced medication reconciliation: a systematic review of the impact on medication errors and adverse drug events associated with transitions of care. | PSNet
     psnet.ahrq.gov/issue/advanced-medication-reconciliation-systematic-review-impact-medication-errors-and-adverse
     December 18, 2017 - Review Advanced medication reconciliation: a systematic review of the impact on medication errors and adverse drug events associated with transitions of care. Citation Text: Killin L, Hezam A, Anderson KK, et al. Advanced medication reconciliation: a systematic review of the impact on me…

477. Year-end resident clinic handoffs: narrative review and recommendations for improvement. | PSNet
     psnet.ahrq.gov/issue/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-improvement
     March 28, 2018 - Review Year-end resident clinic handoffs: narrative review and recommendations for improvement. Citation Text: Pincavage A, Donnelly MJ, Young JQ, et al. Year-End Resident Clinic Handoffs: Narrative Review and Recommendations for Improvement. Jt Comm J Qual Patient Saf. 2017;43(2):71-79.…

478. Workplace violence pervasiveness in the perioperative environment: a multiprofessional survey. | PSNet
     psnet.ahrq.gov/issue/workplace-violence-pervasiveness-perioperative-environment-multiprofessional-survey
     November 11, 2020 - Study Workplace violence pervasiveness in the perioperative environment: a multiprofessional survey. Citation Text: Lin DM, Lane-Fall MB, Lea JA, et al. Workplace violence pervasiveness in the perioperative environment: a multiprofessional survey. Jt Comm J Qual Patient Saf. 2024;50(11):…

479. ICU attending handoff practices: results from a national survey of academic intensivists. | PSNet
     psnet.ahrq.gov/issue/icu-attending-handoff-practices-results-national-survey-academic-intensivists
     February 06, 2019 - Study ICU attending handoff practices: results from a national survey of academic intensivists. Citation Text: Lane-Fall MB, Collard ML, Turnbull AE, et al. ICU Attending Handoff Practices: Results From a National Survey of Academic Intensivists. Crit Care Med. 2016;44(4):690-8. doi:10.1…

480. High delayed and missed injury rate after inter-hospital transfer of severely injured trauma patients. | PSNet
     psnet.ahrq.gov/issue/high-delayed-and-missed-injury-rate-after-inter-hospital-transfer-severely-injured-trauma
     December 02, 2020 - Study High delayed and missed injury rate after inter-hospital transfer of severely injured trauma patients. Citation Text: Hensgens RL, El Moumni M, IJpma FFA, et al. High delayed and missed injury rate after inter-hospital transfer of severely injured trauma patients. Eur J Trauma Emer…