Clinical Areas

Scroll down to search or browse using Clinical Area if you would like to explore PSNet by the healthcare profession, such as the nurse care or medical specialty, featured in the resources.

Latest by Clinical Areas

AHRQ-Funded Patient Safety Project Highlights: Improving Patient Safety by Enhancing Medication Safety.

Rockville, MD: Agency for Healthcare Research and Quality; 2024.

Medication safety refers to practices and measures implemented to reduce the potential for medication errors and adverse drug events in various... Read More

Can we ensure medication safety with the use of speech recognition software?

ISMP Medication Safety Alert! Acute Care. August 22, 2024;29-1-3.

Overconfidence in the accuracy of computerized tools can result in errors being missed or blindly followed. This newsletter article discusses potential problems associated... Read More

Patient Safety: Emerging Applications of Safety Science.

(Cox C, Hughes H, Nicholls J, eds.). Somerset, UK: Class Publishing; 2024.

The Impact of Complications on Surgeons.

Modi PK, Singer EA, eds. Urol Oncol. 2024;42:295-320.

All Clinical Areas (16198)

Displaying 1 - 20 of 16447 Results

Review

Components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review and narrative synthesis.

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Craske ME, Hardeman W, Steel N, et al. BMJ Qual Saf. 2024;Epub Jul 16.

At several points during a hospital stay, a patient may receive a medication review with a pharmacist to reduce the risk of medication errors. This review characterizes themes and components of pharmacist-led medication reviews associated with positive patient outcomes. Patient involvement in goal setting was identified as a successful component that would benefit from additional research.

Commentary

Evaluation and mitigation of the limitations of large language models in clinical decision-making.

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Hager P, Jungmann F, Holland R, et al. Nat Med. 2024;Epub Jul 4.

Researchers, clinicians, and other stakeholders are hopeful that integration of artificial intelligence and large language models (LLMs) can improve patient safety and reduce clinician burden. This study used 2,400 real patient cases to test several LLM's ability to correctly diagnose common abdominal complaints. Each LLM performed significantly worse than physicians, did not follow treatment or diagnostic guidelines, could not interpret laboratory results, and often failed to follow instructions.

Study

Impact of automated alerts on discharge opioid overprescribing after general surgery.

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Rizk E, Kaur N, Duong PY, et al. Am J Health Syst Pharm. 2024;Epub Jul 1.

Overprescribing of opioids for acute pain (such as post-surgical pain) can increase the risk for long-term opioid dependence. This study evaluated whether implementation of an EHR alert reduced opioid overprescribing, defined as opioid prescribing exceeding current recommendations. Among a cohort of patients discharged after surgical procedures commonly associated with overprescribing (laparoscopic cholecystectomy, unilateral open inguinal hernia repair, and laparoscopic appendectomy), researchers identified a significant decrease in opioid overprescribing after the EHR alert implementation (48% pre-implementation to 3% post-implementation). Researchers also observed a significant decrease in the average opioid supply at discharge.

Study

Relationships between medications used in a mental health hospital and types of medication errors: a cross-sectional study over an 8-year period.

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Lebas R, Calvet B, Schadler L, et al. Res Social Adm Pharm. 2024;20:597-604.

The prevalence of medication errors in mental health settings is not well-represented in research. This study used 8 years of medication records to identify when in the medication process the error occurred and was identified, the consequences, type of drug, and root causes. Nearly one-third of errors were wrong dose and occurred in the prescribing stage. The type of error varied widely across medication types (e.g., high-alert, psychotropic).

Study

An exploratory analysis of the association between healthcare associated infections & hospital financial performance.

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Beauvais B, Dolezel D, Shanmugam R, et al. Healthcare (Basel). 2024;12:1314.

Healthcare-associated infections (HAI) can have detrimental results for patients and organizations. This study used HAI and financial data from nearly 1,500 acute care hospitals to assess the association between hospital financial performance and methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff), catheter-associated urinary tract infections (CAUTI), and central line-associated bloodstream infections (CLABSI) infection rates. Each of the HAIs was positively associated with increased hospital costs, underscoring the importance of infection control policies to patient health and hospital financial health.

Study

Reducing ambulatory central line-associated bloodstream infections: a family-centered approach.

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Wong CI, Ilowite M, Yan A, et al. Pediatr Blood Cancer. 2024;71:e31064.

Eliminating central line-associated blood stream infections (CLABSI) remains a patient safety priority. This quality improvement project sought to reduce ambulatory CLABSI rates by improving caregiver management of central lines at home. The intervention included caregiver education, standardized ambulatory nurse CL care practice, and cleaning supplies. The evaluation identified a 52% decrease in ambulatory CLABSI rates, or 117 prevented infections.

Review

The effectiveness of checklists and error reporting systems in enhancing patient safety and reducing medical errors in hospital settings: a narrative review.

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Chance EA, Florence D, Sardi Abdoul I. Int J Nurs Sci. 2024;11:387-398.

Checklists and error reporting systems are designed to improve patient safety. This narrative review highlights the patient safety impacts of each, the similar challenges faced during implementation, and benefits of their use.

Newspaper/Magazine Article

Can we ensure medication safety with the use of speech recognition software?

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ISMP Medication Safety Alert! Acute Care. August 22, 2024;29-1-3.

Overconfidence in the accuracy of computerized tools can result in errors being missed or blindly followed. This newsletter article discusses potential problems associated with the implementation of voice recognition software and highlights simulation, error reporting, and team involvement as avenues to minimize failures in using this technology to support medication processes.

Study

Care home safety incidents and safeguarding reports relating to hospital to care home transitions: a retrospective content analysis.

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Newman C, Mulrine S, Brittain K, et al. J Patient Saf. 2024;Epub Aug 28.

Advancing patient safety in long-term care settings remains a challenge. This analysis of 91 incident reports from care homes in England examined patient safety events that occurred during transitions from hospital to care home. Common incidents included pressure injuries, medication errors, and premature discharge.

Study

Leader safety storytelling: a qualitative analysis of the attributes of effective safety storytelling and its outcomes.

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Benetti PJ, Kanse L, Fruhen LS, et al. Safety Sci. 2024;178:106618.

Storytelling is an effective way to engage workers in safety strategies. In this study, leaders and workers in safety-critical industries describe what effective storytelling looks and sounds like. Six story attributes (e.g., relatability, factuality) and three presentation styles (e.g., delivery style) were identified. Addressing each attribute in their safety storytelling, leaders may more effectively engage workers in maintaining and improving safety.

Special or Theme Issue

The Impact of Complications on Surgeons.

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Modi PK, Singer EA, eds. Urol Oncol. 2024;42:295-320.

Complications and medical errors can result in psychological distress for patients, families, and clinicians. This collection of articles examines this phenomenon in surgical care. Articles included touch on educational, organizational, and personal strategies to reduce the emotional impact of complications on surgeons.

Commentary

Unlocking the potential of free text in electronic health records with large language models (LLM): enhancing patient safety and consultation interactions.

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Kumarapeli P, Haddad T, de Lusignan S. Stud Health Technol Inform. 2024;316:746-750.

Detailed free-text information is collected and recorded in the EHR during primary care consultations, but much of it isn't fully used. This review highlights current challenges with and potential solutions for using large language models (LLMs) to transform clinical notes into rich data sources. LLMs can process free-text information to improve patient care, identify potential issues, and enhance patient-provider communication. Significant LLM fine-tuning and training would be required to make this process more effective.

Book/Report

AHRQ-Funded Patient Safety Project Highlights: Improving Patient Safety by Enhancing Medication Safety.

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Rockville, MD: Agency for Healthcare Research and Quality; 2024.

Medication safety refers to practices and measures implemented to reduce the potential for medication errors and adverse drug events in various healthcare settings. This summary describes 123 AHRQ-supported projects associated with medication safety efforts. The most common strategies tested in this work focused on information technology, error reporting and analysis, and quality improvement. This summary is part of a series describing AHRQ-funded patient safety research; other summaries focus on care coordination and patient and family engagement.

Study

What's the harm? Results of an active surveillance adverse event reporting system for chiropractors and physiotherapists.

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Pohlman KA, Funabashi M, O’Beirne M, et al. PLoS ONE. 2024;19:e0309069.

Voluntary adverse event reporting among chiropractors is an ongoing challenge. Among 2,136 patients with chiropractic or physiotherapist office visits between October 2015 and December 2017, 21% reported experiencing an adverse event 2 to 7 days post-treatment, with the most common events being discomfort/pain, stiffness, and numbness.

Study

Human-AI teaming in critical care: a comparative analysis of data scientists' and clinicians' perspectives on AI augmentation and automation.

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Bienefeld N, Keller E, Grote G. J Med Internet Res. 2024;26:e50130.

Numerous studies have investigated capabilities and accuracy of artificial intelligence (AI) in areas such as diagnosis. This study investigated data scientists' and clinicians' assessments of whether AI could/should be used in certain tasks regardless of AI's current abilities. Both groups said four out of six specified tasks (documentation, analyzing medical data, prescribing, diagnostic decision-making) could be performed by a combination of AI and clinicians. They reported monitoring patient data should be done by AI, and interactions with patients should never be done by AI.

Book/Report

Patient Safety: Emerging Applications of Safety Science.

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(Cox C, Hughes H, Nicholls J, eds.). Somerset, UK: Class Publishing; 2024.

Patient safety improvement builds on a wide array of theories to achieve success. This book highlights activities that support the implementation of foundational concepts such as safety science, human factors, and Safety II to a range of care environments through incident review case-based strategy.

International Meeting/Conference

ISMP Medication Safety Intensive.

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Institute for Safe Medication Practices. September 20 & 27 2024, 7:30 AM - 4:30 PM (eastern).

This virtual workshop will explore tactics for community and specialty pharmacies to ensure medication safety, including strategic planning, risk assessment, and Just Culture principles.

Book/Report

Workforce and Patient Safety.

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Dorset, UK: Health Services Safety Investigations Body; 2024.

The complex health care work environment creates conditions that detract from staff ability to provide safe care. This collection of reports to be developed and distributed over the course of 2024 will cover workforce challenges that can affect the safety of patients and provide recommendations for improvement. The third report in the series, which explores the presence of discrimination against temporary health care workers in the NHS, is now available.

Review

Impact of rounding checklists on the outcomes of patients admitted to ICUs: a systematic review and meta-analysis.

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MacKinnon KM, Seshadri S, Mailman JF, et al. Crit Care Explor. 2024;6:e1140.

Although evidence of their effectiveness is somewhat mixed, checklists are ubiquitous in hospital care. This meta-analysis found some improved patient outcomes (e.g., reduced in-hospital and intensive care unit mortality) in facilities using a rounding checklist in the ICU. Providers had a generally positive perception of rounding checklists, particularly around team collaboration. Further randomized studies are needed to increase certainty of evidence.

Commentary

The problem with 'never events'.

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Zaslow J, Fortier J, Garber G. BMJ Qual Saf. 2024;33:613-616.

Never events are serious, but preventable, adverse events that result in serious patient harm or death. This article compares how organizations define never events with respect to preventability, presence and severity of harm, and public accountability. The authors discuss how varying definitions present challenges in conceptualizing and standardizing never event measurement and reporting.

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