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psnet.ahrq.gov/issue/using-computerized-prescriber-order-entry-limit-overrides-automated-dispensing-cabinets
May 18, 2022 - Commentary
Using computerized prescriber order entry to limit overrides from automated dispensing cabinets.
Citation Text:
Drake E, Srinivas P, Trujillo T. Using computerized prescriber order entry to limit overrides from automated dispensing cabinets. Am J Health-Syst Pharm. 2016;73(14)…
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psnet.ahrq.gov/issue/why-stigma-matters-addressing-alcohol-harm
August 04, 2021 - Commentary
Why stigma matters in addressing alcohol harm.
Citation Text:
Morris J, Schomerus G. Why stigma matters in addressing alcohol harm. Drug Alcohol Rev. 2023;42(5):1264-1268. doi:10.1111/dar.13660.
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psnet.ahrq.gov/issue/model-disruptive-surgeon-behavior-perioperative-environment
February 05, 2020 - Study
A model of disruptive surgeon behavior in the perioperative environment.
Citation Text:
Cochran A, Elder WB. A model of disruptive surgeon behavior in the perioperative environment. J Am Coll Surg. 2014;219(3):390-8. doi:10.1016/j.jamcollsurg.2014.05.011.
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psnet.ahrq.gov/issue/impact-senior-clinical-review-patient-disposition-emergency-department
August 28, 2024 - Study
Impact of senior clinical review on patient disposition from the emergency department.
Citation Text:
White AL, Armstrong PAR, Thakore S. Impact of senior clinical review on patient disposition from the emergency department. Emerg Med J. 2010;27(4):262-5, 296. doi:10.1136/emj.200…
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www.ahrq.gov/sops/about/index.html
July 01, 2024 - About the SOPS Program
Since 2001, the AHRQ Surveys on Patient Safety Culture® (SOPS®) Program has supported AHRQ's mission by advancing the scientific understanding of patient safety culture in healthcare settings. What Is Patient Safety Culture? Patient safety culture is an aspect of an organization's cultu…
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psnet.ahrq.gov/issue/advising-patients-about-patient-safety-current-initiatives-risk-shifting-responsibility
May 20, 2015 - Commentary
Advising patients about patient safety: current initiatives risk shifting responsibility.
Citation Text:
Entwistle V, Mello MM, Brennan TA. Advising Patients About Patient Safety: Current Initiatives Risk Shifting Responsibility. Jt Comm J Qual Patient Saf. 2005;31(9):483-494.…
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psnet.ahrq.gov/issue/anesthesia-patient-safety-foundation-stoelting-conference-2019-perioperative-deterioration
October 19, 2022 - Meeting/Conference Proceedings
The Anesthesia Patient Safety Foundation Stoelting Conference 2019: perioperative deterioration--early recognition, rapid intervention, and the end of failure-to-rescue.
Citation Text:
Lin D, Peden CJ, Langness SM, et al. The Anesthesia Patient Safety Found…
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psnet.ahrq.gov/issue/making-healthcare-safer-iii
March 27, 2019 - Book/Report
Making Healthcare Safer III.
Citation Text:
Making Healthcare Safer III. Holmes A, Long A, Wyant B, et al. Rockville, MD: Agency for Healthcare Research and Quality; March 2020. AHRQ Publication No. 20-0029-EF.
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psnet.ahrq.gov/issue/bridging-gap-leveraging-business-intelligence-tools-support-patient-safety-and-financial
February 15, 2011 - Commentary
Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness.
Citation Text:
Ferranti JM, Langman MK, Tanaka D, et al. Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effe…
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psnet.ahrq.gov/issue/intensive-care-units-communication-between-nurses-and-physicians-and-patients-outcomes
May 28, 2008 - Study
Intensive care units, communication between nurses and physicians, and patients' outcomes.
Citation Text:
Manojlovich M, Antonakos CL, Ronis DL. Intensive care units, communication between nurses and physicians, and patients' outcomes. Am J Crit Care. 2009;18(1):21-30. doi:10.403…
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psnet.ahrq.gov/issue/mistaken-identity-skin-cleansing-solution-leading-extensive-chemical-burns-extremely-preterm
October 19, 2022 - Commentary
Mistaken identity of skin cleansing solution leading to extensive chemical burns in an extremely preterm infant.
Citation Text:
Mannan K, Chow P, Lissauer T, et al. Mistaken identity of skin cleansing solution leading to extensive chemical burns in an extremely preterm infan…
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psnet.ahrq.gov/issue/increased-mortality-associated-after-hours-and-weekend-admission-intensive-care-unit
May 31, 2023 - Study
Increased mortality associated with after-hours and weekend admission to the intensive care unit: a retrospective analysis.
Citation Text:
Bhonagiri D, Pilcher D, Bailey MJ. Increased mortality associated with after-hours and weekend admission to the intensive care unit: a retros…
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psnet.ahrq.gov/issue/surgical-management-and-outcomes-165-colonoscopic-perforations-single-institution
November 16, 2022 - Study
Surgical management and outcomes of 165 colonoscopic perforations from a single institution.
Citation Text:
Iqbal CW, Cullinane DC, Schiller HJ, et al. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Arch Surg. 2008;143(7):701-6; discu…
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psnet.ahrq.gov/issue/systematic-review-unintended-consequences-clinical-interventions-reduce-adverse-outcomes
November 15, 2023 - Review
A systematic review of the unintended consequences of clinical interventions to reduce adverse outcomes.
Citation Text:
Manojlovich M, Lee S, Lauseng D. A Systematic Review of the Unintended Consequences of Clinical Interventions to Reduce Adverse Outcomes. J Patient Saf. 2016;12(…
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psnet.ahrq.gov/issue/sustained-improvement-neonatal-intensive-care-unit-safety-attitudes-after-teamwork-training
March 26, 2015 - Study
Sustained improvement in neonatal intensive care unit safety attitudes after teamwork training.
Citation Text:
Murphy T, Laptook A, Bender J. Sustained Improvement in Neonatal Intensive Care Unit Safety Attitudes After Teamwork Training. J Patient Saf. 2018;14(3):174-180. doi:10.10…
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psnet.ahrq.gov/issue/perceived-value-ward-based-pharmacists-perspective-physicians-and-nurses
February 15, 2011 - Study
Perceived value of ward-based pharmacists from the perspective of physicians and nurses.
Citation Text:
Gillespie U, Mörlin C, Hammarlund-Udenaes M, et al. Perceived value of ward-based pharmacists from the perspective of physicians and nurses. Int J Clin Pharm. 2012;34(1):127-35…
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psnet.ahrq.gov/issue/hospital-incident-reporting-systems-do-not-capture-most-patient-harm
September 20, 2011 - Book/Report
Hospital Incident Reporting Systems Do Not Capture Most Patient Harm.
Citation Text:
Hospital Incident Reporting Systems Do Not Capture Most Patient Harm. Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; January 201…
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psnet.ahrq.gov/issue/incoming-interns-recognize-inadequate-physical-examination-cause-patient-harm
July 20, 2022 - Study
Incoming interns recognize inadequate physical examination as a cause of patient harm.
Citation Text:
Russo S, Berg K, Davis JJ, et al. Incoming interns recognize inadequate physical examination as a cause of patient harm. J Med Educ Curric Dev. 2020;7:238212052092899. doi:10.1177/…
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psnet.ahrq.gov/issue/americans-experiences-medical-errors-and-views-patient-safety
January 06, 2015 - Book/Report
Classic
Americans' Experiences With Medical Errors and Views on Patient Safety.
Citation Text:
Americans' Experiences With Medical Errors and Views on Patient Safety. Chicago, IL: NORC at the University of Chicago and IHI/NPSF Lucian Leape Institute;…
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psnet.ahrq.gov/issue/courage-speak-out-study-describing-nurses-attitudes-report-unsafe-practices-patient-care
April 24, 2018 - Study
The courage to speak out: a study describing nurses' attitudes to report unsafe practices in patient care.
Citation Text:
Cole DA, Bersick E, Skarbek A, et al. The courage to speak out: A study describing nurses' attitudes to report unsafe practices in patient care. J Nurs Manag. 2…