Skip to main content

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.

Search All Content

Search Tips
Save
Selection
Format
Download
Published Date
Original Publication Date
Original Publication Date
PSNet Publication Date
Narrow Results By
PSNet Original Content
Commonly Searched Resource Types
Displaying 1 - 9 of 9 Results

Washington, DC: United States Government Accountability Office; Publication GAO-22-105133. September 14, 2022.

COVID-19 generated unprecedented challenges for the nursing home industry, revealing and amplifying process, staffing, trust, and infection control weaknesses to the detriment of care. This report analyzed current infection protection actions in long-term care. A primary improvement conclusion drawn from the examination is to strengthen the role of infection control professionals.

ECRI. Plymouth Meeting, PA. March 2022.

The global COVID-19 pandemic has exacerbated patient safety concerns. ECRI presents the top ten patient concerns for 2022, including staffing challenges, human factors in telehealth, and supply chain disruptions.

Issue Brief. Washington DC: Pew Charitable Trust; March 2021.

Antibiotic overuse is a contributor to nosocomial infection. This report discusses problems associated with antibiotic prescribing during the first 6 months of the COVID-19 pandemic. Systemic problems arising from the situation include disparities associated with antibiotic administration and unneeded receipt of medications by some patients.

La Regina M, Tanzini M, Venneri F, et al for the Italian Network for Health Safety. Dublin, Ireland: International Society for Quality in Health Care; 2021.

The COVID-19 pandemic is a rapidly evolving situation that requires a system orientation to diagnosis, management and post-acute care to keep clinicians, patients, families and communities safe. This set of recommendations is anchored on a human factors approach to provide overarching direction to design systems and approaches to respond to the virus. The recommendations focus on team communication and organizational culture; the diagnostic process; patient and family engagement to reduce spread; hospital, pediatric, and maternity processes and treatments; triage decision ethics; discharge communications; home isolation; psychological safety of staff and patients, and; outcome measures. An appendix covers drug interactions and adverse effects for medications used to treat this patient population. The freely-available full text document will be updated appropriately as Italy continues to respond, learn and amend its approach during the outbreak.

Geneva, Switzerland: World Health Organization; September 17, 2020.

The intersection of worker well-being and safety with patient harm prevention has become apparent due to COVID-19. This report discusses five areas of importance in motivating lasting change in health care environments to support the safety of the work force. It highlights policy and strategy alignment, occupational considerations, violence reduction, psychological concerns, and physiological harms as essential elements of a robust approach to workforce safety improvement. 

London, UK: General Medical Council; September 14, 2020.

Physician caregiving effectiveness can be tested during crisis situations. This guidance shares recommendations for leaders assessing complaints against physicians during the COVID-19 pandemic to consider extenuating circumstances when determining next steps in managing the response to poor care delivery. 

Washington, DC: United States Government Accountability Office; May 20, 2020. Publication GAO-20-576R.   

This US Government Accountability Office (GAO) report highlights the chronic shortfalls in nursing home infection control programs. The GAO analyzed survey data from the Centers for Medicare & Medicaid Services (CMS) and found 82% (13,299) of nursing homes surveyed were cited in one or more years between 2013-2017 and in each individual year, 40% of nursing homes had infection control and prevention deficiencies that continued through 2018 and 2019.  While the majority of the citations did not indicate harm to nursing home residents and were rarely associated with enforcement actions, the GAO intends to examine CMS oversight of infection and control in the near future.  In light of the COVID-19 pandemic, these findings are particularly concerning.

National Academies of Sciences, Engineering, and Medicine. Washington, DC; The National Academies Press: 2020. ISBN 9780309676250.

Patient safety is challenged during public health emergencies. This report examines a 10-year initiative to develop crisis preparedness standards. The material covers how to proactively apply the program’s experience to assess legal and ethical considerations, learn from federal and state initiatives, address challenges and design steps to continue progress.