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  1. Supplement on Deepening our Understanding of Quality in Australia (DUQuA). | PSNet

    psnet.ahrq.gov/issue/supplement-deepening-our-understanding-quality-australia-duqua
    February 04, 2009 - Special or Theme Issue Supplement on Deepening our Understanding of Quality in Australia (DUQuA). Citation Text: Supplement on Deepening our Understanding of Quality in Australia (DUQuA). Int J Qual Health Care. 2020;32(Supp1):1-105. Copy Citation Save Save t…

  2. Preventing home medication administration errors. | PSNet

    psnet.ahrq.gov/issue/preventing-home-medication-administration-errors
    March 03, 2019 - Organizational Policy/Guidelines Preventing home medication administration errors. Citation Text: Yin HS, Neuspiel DR, Paul IM, et al. Preventing home medication administration errors. Pediatrics. 2021;148(6):e2021054666. doi:10.1542/peds.2021-054666. Copy Citation Format: …

  3. Retained surgical items and minimally invasive surgery. | PSNet

    psnet.ahrq.gov/issue/retained-surgical-items-and-minimally-invasive-surgery
    April 28, 2021 - Commentary Retained surgical items and minimally invasive surgery. Citation Text: Gibbs VC. Retained surgical items and minimally invasive surgery. World J Surg. 2011;35(7):1532-9. doi:10.1007/s00268-011-1060-4. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNo…

  4. A system-wide initiative to prevent retained vaginal sponges. | PSNet

    psnet.ahrq.gov/issue/system-wide-initiative-prevent-retained-vaginal-sponges
    November 07, 2012 - Commentary A system-wide initiative to prevent retained vaginal sponges. Citation Text: Chagolla BA, Gibbs VC, Keats JP, et al. A system-wide initiative to prevent retained vaginal sponges. MCN Am J Matern Child Nurs. 2011;36(5):312-317. doi:10.1097/NMC.0b013e31822ab204. Copy Citatio…

  5. Fixing patient safety: are we nearly there yet? | PSNet

    psnet.ahrq.gov/issue/fixing-patient-safety-are-we-nearly-there-yet
    April 14, 2021 - Commentary Fixing patient safety: are we nearly there yet? Citation Text: McCulloch P. Fixing patient safety: are we nearly there yet? BMJ Qual Saf. 2024;33(8):539-542. doi:10.1136/bmjqs-2023-016589. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 X…

  6. Why a sociotechnical framework is necessary to address diagnostic error. | PSNet

    psnet.ahrq.gov/issue/why-sociotechnical-framework-necessary-address-diagnostic-error
    September 14, 2022 - Commentary Why a sociotechnical framework is necessary to address diagnostic error. Citation Text: Ladell MM, Yale S, Bordini BJ, et al. Why a sociotechnical framework is necessary to address diagnostic error. BMJ Qual Saf. 2024;33(12):823-828. doi:10.1136/bmjqs-2024-017231. Copy Citat…

  7. Obstetric practice guidelines: labor's love lost? | PSNet

    psnet.ahrq.gov/issue/obstetric-practice-guidelines-labors-love-lost
    April 30, 2014 - Commentary Obstetric practice guidelines: labor's love lost? Citation Text: Cohen WR, Friedman EA. Obstetric practice guidelines: labor's love lost? J Matern Fetal Neonatal Med. 2019;32(9):1567-1570. doi:10.1080/14767058.2017.1406474. Copy Citation Format: DOI Google Schola…

  8. Ethical duty of health care systems to address interfacility medical error discovery. | PSNet

    psnet.ahrq.gov/issue/ethical-duty-health-care-systems-address-interfacility-medical-error-discovery
    September 11, 2019 - Commentary Ethical duty of health care systems to address interfacility medical error discovery. Citation Text: Antunez AG, Shuman AG, Jagsi R, et al. Ethical Duty of Health Care Systems to Address Interfacility Medical Error Discovery. J Am Coll Surg. 2018;227(5):543-547. doi:10.1016/j.…

  9. ACR guidance document on MR safe practices: 2013. | PSNet

    psnet.ahrq.gov/issue/acr-guidance-document-mr-safe-practices-2013
    November 18, 2016 - Commentary ACR guidance document on MR safe practices: 2013. Citation Text: Safety EP on, Kanal E, Barkovich J, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 2013;37(3):501-530. doi:10.1002/jmri.24011. Copy Citation Format: DOI Google Scho…

  10. Transition of care for hospitalized elderly patients—development of a discharge checklist for hospitalists. | PSNet

    psnet.ahrq.gov/issue/transition-care-hospitalized-elderly-patients-development-discharge-checklist-hospitalists
    November 16, 2022 - Commentary Transition of care for hospitalized elderly patients—development of a discharge checklist for hospitalists. Citation Text: Halasyamani L, Kripalani S, Coleman E, et al. Transition of care for hospitalized elderly patients—Development of a discharge checklist for hospitalists…

  11. Partnership for Patients. | PSNet

    psnet.ahrq.gov/issue/partnership-patients
    October 30, 2019 - Government Resource Partnership for Patients. Citation Text: Partnership for Patients. Washington, DC: US Department of Health and Human Services. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter L…

  12. Disclosing medical errors to patients: effects of nonverbal involvement. | PSNet

    psnet.ahrq.gov/issue/disclosing-medical-errors-patients-effects-nonverbal-involvement
    June 14, 2017 - Study Disclosing medical errors to patients: effects of nonverbal involvement. Citation Text: Hannawa AF. Disclosing medical errors to patients: effects of nonverbal involvement. Patient Educ Couns. 2014;94(3):310-313. doi:10.1016/j.pec.2013.11.007. Copy Citation Format: DO…

  13. Medication safety initiative in reducing medication errors. | PSNet

    psnet.ahrq.gov/issue/medication-safety-initiative-reducing-medication-errors
    June 09, 2015 - Study Medication safety initiative in reducing medication errors. Citation Text: Nguyen EE, Connolly PM, Wong V. Medication safety initiative in reducing medication errors. J Nurs Care Qual. 2010;25(3):224-230. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 X…

  14. Development of the pharmacy safety climate questionnaire: a principal components analysis. | PSNet

    psnet.ahrq.gov/issue/development-pharmacy-safety-climate-questionnaire-principal-components-analysis
    April 06, 2011 - Study Development of the pharmacy safety climate questionnaire: a principal components analysis. Citation Text: Ashcroft DM, Parker D. Development of the pharmacy safety climate questionnaire: a principal components analysis. Qual Saf Health Care. 2009;18(1):28-31. doi:10.1136/qshc.200…

  15. Statewide identification of adverse events using retrospective nurse review: methods and outcomes. | PSNet

    psnet.ahrq.gov/issue/statewide-identification-adverse-events-using-retrospective-nurse-review-methods-and-outcomes
    November 21, 2021 - Study Statewide identification of adverse events using retrospective nurse review: methods and outcomes. Citation Text: Silver MP, Hougland P, Elder S, et al. Statewide identification of adverse events using retrospective nurse review: methods and outcomes. J Nurs Meas. 2007;15(3):220-…

  16. The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. | PSNet

    psnet.ahrq.gov/issue/nursing-home-expert-panels-falls-investigation-guide-toolkit-how-guide
    January 09, 2025 - Tools/Toolkit The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. Citation Text: The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. Portland, OR: Oregon Patient Safety Commission; 2022.  Copy Citation Sav…

  17. Patient safety and quality improvement: terminology. | PSNet

    psnet.ahrq.gov/issue/patient-safety-and-quality-improvement-terminology
    August 18, 2021 - Review Patient safety and quality improvement: terminology. Citation Text: Pereira-Argenziano L, Levy FH. Patient Safety and Quality Improvement: Terminology. Pediatr Rev. 2015;36(9):403-11; quiz 412-3. doi:10.1542/pir.36-9-403. Copy Citation Format: DOI Google Scholar PubM…

  18. Shedding light on the dark side of doctor–patient interactions: verbal and nonverbal messages physicians communicate during error disclosures. | PSNet

    psnet.ahrq.gov/issue/shedding-light-dark-side-doctor-patient-interactions-verbal-and-nonverbal-messages-physicians
    June 14, 2017 - Study Shedding light on the dark side of doctor–patient interactions: verbal and nonverbal messages physicians communicate during error disclosures. Citation Text: Hannawa AF. Shedding light on the dark side of doctor-patient interactions: verbal and nonverbal messages physicians commu…

  19. Creating a comprehensive, unit-based approach to detecting and preventing harm in the neonatal intensive care unit. | PSNet

    psnet.ahrq.gov/issue/creating-comprehensive-unit-based-approach-detecting-and-preventing-harm-neonatal-intensive
    December 15, 2021 - Commentary Creating a comprehensive, unit-based approach to detecting and preventing harm in the neonatal intensive care unit. Citation Text: Creating a comprehensive, unit-based approach to detecting and preventing harm in the neonatal intensive care unit. Sedlock EW, Ottosen M, Nether …

  20. Improving the communication between teams managing boarded patients on a surgical specialty ward. | PSNet

    psnet.ahrq.gov/issue/improving-communication-between-teams-managing-boarded-patients-surgical-specialty-ward
    September 29, 2017 - Commentary Improving the communication between teams managing boarded patients on a surgical specialty ward. Citation Text: Puvaneswaralingam S, Ross D. Improving the communication between teams managing boarded patients on a surgical specialty ward. BMJ Qual Improv Rep. 2016;5(1). doi:1…
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