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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.

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Displaying 1 - 20 of 41 Results
Long Y, Hu T, Liu L, et al. J Evid Based Med. 2020.
This systematic review pooled data from six trials involving over 9,100 patients to assess the effectiveness of N95 respirators versus surgical masks for flu prevention in hospital and community settings. The meta-analysis found no significant difference between N95 respirators and surgical masks in preventing laboratory- confirmed influenza, respiratory infections or influenza-like illness. The authors conclude that N95 respirators should not be recommended for the general public and should be reserved for high-risk medical staff in close contact with diagnosed or suspected influenza patients.  
Lai J, Ma S, Wang Y, et al. JAMA Netw Open. 2020;3:e203976.
Healthcare workers on the frontlines of the COVID-19 pandemic are at risk for adverse psychological impacts. This cross-sectional survey evaluated mental health outcomes affecting healthcare workers treating patients exposed to COVID-19 in China. The 1,257 survey respondents reported symptoms of distress (72%), depression (50%), anxiety (45%) and insomnia (34%). Those engaged directly in the diagnosis, treatment and care of patients with COVID-19 were at greater risk for symptoms of depression (odds ratio [OR]=1.52; 95% CI, 1.11-2.09), anxiety (OR=1.57; 95% CI, 1.22-2.02), insomnia (OR=2.97; 95% CI, 1.92-4.60), and distress (OR=1.60; 95% CI, 1.25-2.04). The authors conclude that special interventions to promote the mental well-being of healthcare workers treating patients with COVID-19 need to be immediately implemented in order to reduce psychological burden.
Cai H, Tu B, Ma J, et al. Med Sci Monit. 2020;26:e924171.
Production pressure – the pressure to continue to work at maximum capacity – presents risks to patient safety. This study reported on a survey of 534 healthcare providers and hospital staff in the Hunan province of China about the psychological impact of COVID-19. Respondents cited moral and social responsibility as being the strongest driver to continue working long hours during the outbreak and expressed anxiety and concerns regarding their safety, the safety of their families, and high mortality among their patients. Recognition of healthcare staff by hospital management and government, strong infection control guidelines, and specialized equipment and facilities for the management of COVID‑19 were reported as factors that mitigated psychological burnout.

Chui MA, Pohjanoksa-Mäntylä M, Snyder ME, eds. Res Social Adm Pharm. 2019;15(7):811-906.

Medication safety is a worldwide challenge. This special issue discusses factors affecting the reliability of the ordering, dispensing, and administration of medications across a range of environments. Articles cover topics such as the need to deepen understanding of safety in community pharmacies, the use of smart pumps for high-alert medications, and the international effort to reduce medication-related harm.
Chen Y-F, Armoiry X, Higenbottam C, et al. BMJ Open. 2019;9:e025764.
Patients admitted to the hospital on the weekend have been shown to experience worse outcomes compared to those admitted on weekdays. This weekend effect has been observed numerous times across multiple health care settings. However, whether patient characteristics (patients admitted on the weekend may be more severely ill) or system factors (less staffing and certain services may not be available on the weekend) are primarily responsible remains debated. In this systematic review and meta-analysis including 68 studies, researchers found a pooled odds ratio for weekend mortality of 1.16. Moreover, the weekend effect in these studies was more pronounced for elective rather than unplanned admissions. They conclude that the evidence suggesting that the weekend effect reflects worse quality of care is of low quality. A past PSNet perspective discussed the significance of the weekend effect with regard to cardiology.
Sholl S, Scheffler G, Monrouxe L, et al. BMJ Open. 2019;9:e025615.
This interview study examined multiple stakeholder perspectives, including patients, nurses, trainees, and attending physicians, on safety and dignity in health care settings. They cited the importance of safety culture and reported experiencing dilemmas in supporting safety and dignity in the hospital. The authors suggest that graduate medical education explicitly incorporate these concepts.
Lee W-H, Zhang E, Chiang C-Y, et al. J Patient Saf. 2019;15:61-68.
Trigger tools and incident reporting are widely utilized methods for detecting harm in health care. The most useful method for capturing safety events in the emergency department remains unknown. In this prospective observational study, researchers assessed a monitoring system designed to detect adverse events in the emergency department of an academic medical center over a 1-year period. The system included two event reporting methods and five trigger tools. Of the 285 adverse events identified during the study period, 77.2% were captured by reporting systems, 26% by trigger tools, and 3.2% by both approaches. In keeping with prior research, the authors conclude that the use of a combination of methods for capturing harm is more effective than the use of a singular approach. A past PSNet perspective highlighted the importance of feedback with regard to incident reporting.
Liang H, Tsui BY, Ni H, et al. Nat Med. 2019;25:433-438.
Artificial intelligence may have the potential to improve patient safety by enhancing diagnostic capability. In this study, researchers applied machine learning techniques to a large amount of pediatric electronic health record data and found that their model was able to achieve diagnostic accuracy analogous to that of skilled pediatricians.
Yue L, Plummer V, Cross W. J Clin Nurs. 2017;26:2511-2526.
Managing alarms in clinical settings is a patient safety challenge for nurses. This systematic review of nursing educational interventions intended to enhance alarm management suggests that education either in simulated or actual clinical practice settings can help nurses manage clinical alarms safely.
Chen C, Kan T, Li S, et al. Am J Emerg Med. 2016;34.
Process and procedure consistency contributes to safe, highly reliable health care. This review examined the literature on the use of standard operating procedures and checklists in prehospital emergency medicine and found encouraging results on safety improvements associated with such interventions in this practice environment.
Wu X, Wu C, Zhang K, et al. Int J Med Inform. 2016;88:25-33.
Computerized provider order entry can improve medication safety, but numeric entry errors may still occur. This study found that numeric entry errors are more common in urgent situations and when numbers are entered from a main keyboard rather than a numeric keypad. This work underscores the importance of interface design in safety improvement efforts.
Mao X, Jia P, Zhang L, et al. PLoS One. 2015;10:e0129948.
Human factors engineering has been increasingly applied in health care. This systematic review found that while human factors engineering interventions often improved health care worker outcomes and patient safety, most studies were of moderate or low quality and few considered the relevant costs of the programs.
Wang H-F, Jin J-F, Feng X-Q, et al. Ther Clin Risk Manag. 2015;11:393-406.
A hospital in the People's Republic of China was able to achieve a significant reduction in medication administration errors through a multidisciplinary quality improvement effort. The initiative included organizational measures, information technology interventions, quality improvement tools, and process optimization.
Wang C-J, Fetzer SJ, Yang Y-C, et al. Geriatr Nurs. 2013;34:138-45.
The use of trained community volunteers resulted in improved medication safety knowledge and behaviors among elderly patients with chronic illness in a rural area. This study is notable as there is very little research on methods to augment patient safety in ambulatory care outside of urban settings.