Many healthcare professionals experienced adverse emotional and psychological outcomes during the COVID-19 pandemic. This survey of 665 health system pharmacists found that pharmacists working in settings with higher levels of workplace wellness support were less likely to experience depression, anxiety, or burnout, and report higher levels of professional quality of life during the COVID-19 pandemic.

Ensuring all pregnant individuals receive safe maternal care is a national health priority. Using a large national database, this study describes trends in delivery-related severe maternal morbidity (SMM) and mortality in the United States. Maternal mortality decreased for all racial, ethnic, and age groups, while SMM increased for all groups, particularly racial and ethnic minoritized groups. Patients with COVID-19 had a significantly increased risk of death. PSNet features a curated library of maternal safety resources.

A “just culture” balances organizational responsibility and individual accountability after an error occurs. This integrative review of 16 articles identified four concepts critical to implementing a “just culture” in healthcare settings – leadership commitment, education and training, accountability, and open communication.

Standard precautions, including hand hygiene and sharps safety, keep patients and staff safe, but adherence is suboptimal. An earlier systematic review shows an association between standard precaution compliance and overall safety climate. This study aimed to determine if adherence to standard precautions and safety climate were associated with healthcare associated infection (HAI) rates. Adherence rates were low (64%) and associated with HAI and healthcare worker needlesticks.

… J Am Med Inform Assoc … Problem lists , while an important … health records (EHR) (medication ordered lacking a corresponding problem on the problem list) in two different … hospitals using different EHRs. Both sites resulted in a proportion of new problems being added to the problem list …

The overprescribing of opiates is a known contributor to the opioid epidemic. This essay describes governmental action taken to adjust prescribing patterns, their effect, and strategies to increase the impact of these actions on opioid misuse and patient harm.

… settings such as critical care. This paper describes a “hackathon” – an intensive problem-solving event commonly …

… and increased patient turnover at three sites within a single academic medical center. Consistent with prior …

… J Nurs Care Qual … J Nurs Care Qual … This cross-sectional study examined … to reduce missed nursing care and improve safety. … Hessels AJ, Paliwal M, Weaver SH, Siddiqui D, Wurmser TA. … on Missed Nursing Care and Adverse Patient Events.  J Nurs Care Qual . 2019;34(4):287–294. …

… of the National Association for Healthcare Quality … J Healthc Qual … Researchers tested and validated a survey to measure safety culture in pediatric long-term …

Workplace violence in the health care setting is common and poses an ongoing risk for providers and staff. The Joint Commission issued a sentinel event alert to raise awareness about the risks associated with physical and verbal violence against health care workers and suggests numerous strategies organizations can use to address the problem, including establishing reporting systems and developing quality improvement interventions. The authors describe a quality improvement initiative involving the development and iterative testing of a huddle handoff tool to optimize communication between the emergency department (ED) and an admitting unit regarding patients with the potential for violent behavior. The huddle tool led to improved perceptions of safety during the patient transfer process by both the ED nurses and the admitting medical units. An accompanying editorial highlights the importance of taking a systems approach to address workplace safety. A PSNet perspective explored how a medical center developed a process to identify, prioritize, and mitigate hazards in health care settings.

This matched case-control study examined costs and payments to hospitals related to hospital-acquired central line infections and catheter-associated urinary tract infections. Investigators found that hospitals could either experience financial penalty or gain depending on the particular payment structure for the patient. They suggest aligning payment structures more closely with safety goals.

Improving the culture of safety within health care is an essential component of preventing errors. This commentary discusses the culture of radiology in the context of recent progress in understanding and reducing diagnostic error. The authors suggest that peer-oriented feedback and assessment would drive progress in improving safety in radiology.

… J Patient Saf … Patients' perceptions of care may provide … patients seen in an academic emergency department over a one-year period. They found that patients were able to … accurately identify adverse events and near misses, only a small fraction of which were also submitted to an existing …

… … JAMA Intern Med … Clostridium difficile diarrhea is a common and highly morbid health care–associated infection . This study demonstrated that when a hospitalized patient receives antibiotics, the next patient …

… The Journal of hospital infection … J Hosp Infect … All seven articles included in this systematic review showed a statistically significant association between better safety …

… patients. This commentary describes an incident involving a patient with moderate dementia that worsened when opioids were prescribed following a fall. After a geriatrician evaluated the patient and suspected …