The PSNet Collection

The PSNet Collection: All Content

The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.

Guideline for opioid therapy and chronic noncancer pain.

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Busse JW, Craigie S, Juurlink DN, et al. CMAJ. 2017;189:E659-E666.

Opioid pain medications carry high risk for adverse drug events, and opioid misuse is a growing patient safety concern. This guideline provides recommendations to augment safe prescribing of these high-risk medications for patients with chronic noncancer pain.

Rate of undesirable events at beginning of academic year: retrospective cohort study.

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Haller G, Myles PS, Taffé P, et al. BMJ. 2009;339:b3974.

… of inexperienced residents and students, has long been a source of gallows humor in hospitals. Although prior … this Australian study of anesthesia errors did find a significant increase in preventable adverse events for … provide adequate supervision and support for new trainees. A case of inadvertent hypoglycemia resulting from an intern's …

The Swiss cheese model of safety incidents: are there holes in the metaphor?

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Perneger T. BMC Health Serv Res. 2005;5:71.

The author examined the varying interpretations of Reason's Swiss cheese model and found considerable variation among health care professionals.

Patient reports of undesirable events during hospitalization.

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Agoritsas T, Bovier PA, Perneger T. J Gen Intern Med. 2005;20:922-8.

The authors surveyed adults recently discharged from a Swiss hospital and found that patients can effectively pinpoint in-hospital adverse events.

Hand hygiene among physicians: performance, beliefs, and perceptions.

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Pittet D, Simon A, Hugonnet S, et al. Ann Intern Med. 2004;141:1-8.

… directly observed and surveyed more than 160 physicians at a large university hospital to describe current practices and … wide variations across medical specialties. Whereas being a role model, having a positive attitude towards hand hygiene, and easy access to …

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