AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (242)

•Diagnostic Errors (158)

•Identification Errors (126)

•Discontinuities, Gaps, and Hand-Off Problems (333)

•Fatigue and Sleep Deprivation (86)

•Medication Safety (860)

•Medical Complications (366)

•Nonsurgical Procedural Complications (101)

•Surgical Complications (689)

•Transfusion Complications (15)

•Psychological and Social Complications (120)

Origin/Sponsor

•Africa (1)

•Asia (21)

•Australia and New Zealand (45)

•Central and South America (3)

•Europe (280)

•North America (3209)

Resource Types

•Clinical Guideline (9)

•Journal Article (2463)

•Legislation/Regulation (52)

•Meeting/Conference (40)

•Newsletter/Journal (13)

•Newspaper/Magazine Article (398)

•Press Release/Announcement (33)

•Special or Theme Issue (75)

•Tools/Toolkit (59)

•Web Resource (125)

•Grant (13)

Error Types

•Epidemiology of Errors and Adverse Events (708)

•Active Errors (516)

•Latent Errors (209)

•Near Miss (66)

Approach to Improving Safety

•Quality Improvement Strategies (1141)

•Legal and Policy Approaches (404)

•Error Reporting and Analysis (990)

•Communication Improvement (835)

•Human Factors Engineering (589)

•Teamwork (318)

•Specialization of Care (178)

•Logistical Approaches (214)

•Culture of Safety (478)

•Technologic Approaches (533)

•Education and Training (659)

Clinical Areas

•Allied Health Services (10)

Target Audience

•Health Care Providers (2821)

•Health Care Executives and Administrators (2805)

•Non-Health Care Professionals (1372)

•Patients (303)

Setting of Care

•Hospitals (2121)

•Psychiatric Facilities (12)

•Residential Facilities (56)

•Ambulatory Care (304)

•Outpatient Surgery (49)

•Patient Transport (26)

1 - 20 of 3589

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STUDY

Management of anesthesia equipment failure: a simulation-based resident skill assessment.

Waldrop WB, Murray DJ, Boulet JR, Kras JF. Anesth Analg. 2009;109:426-433.

REVIEW

International advocacy for education and safety.

McQueen KA, Malviya S, Gathuya ZN, Tyler DC, Davidson A. Paediatr Anaesth. 2012;22:962-968.

COMMENTARY

MRI suites: safety outside the bore.

Gilk T. Patient Saf Qual Healthc. September/October 2006;3:16-18, 20-21.

STUDY

Acquisition of critical intraoperative event management skills in novice anesthesiology residents by using high-fidelity simulation-based training.

Park CS, Rochlen LR, Yaghmour E, et al. Anesthesiology. 2010;112:202-211.

SPECIAL OR THEME ISSUE

Quality of Anesthesia Care.

Neuman MD, Martinez EA, eds. Anesthesiol Clin. 2011;29:1-178.

STUDY

Usability study of two common defibrillators reveals hazards.

Fairbanks RJ, Caplan SH, Bishop PA, Marks AM, Shah MN. Ann Emerg Med. 2007;50:424-432.

NEWSPAPER/MAGAZINE ARTICLE

Preventing catheter/tubing misconnections: much needed help is on the way.

ISMP Medication Safety Alert! Acute Care Edition. July 15, 2010;15:1-2.

STUDY

Identifying and categorising patient safety hazards in cardiovascular operating rooms using an interdisciplinary approach: a multisite study.

Gurses AP, Kim G, Martinez EA, et al. BMJ Qual Saf. 2012;21:810-818.

STUDY

Quality improvement project to reduce perioperative opioid oversedation events in a paediatric hospital.

Vermaire D, Caruso MC, Lesko A, et al. BMJ Qual Saf. 2011;20:895-902.

STUDY

Reducing adverse drug events: lessons from a breakthrough series collaborative.

Leape LL, Kabcenell A, Gandhi TK, Carver P, Nolan TW, Berwick DM. Jt Comm J Qual Improv. 2000;26:321-331.

NEWSPAPER/MAGAZINE ARTICLE

Pharmaceutical industry and medical device companies: part of the solution?

ISMP Medication Safety Alert! Acute Care Edition. November 16, 2006;11:1, 3.

NEWSPAPER/MAGAZINE ARTICLE

The day Joy died.

Brandeland GP. Med Econ. 2006 Oct 20;83:50, 52-53.

COMMENTARY

Epidural pump programming error leading to inadvertent 10-fold dosing error during epidural labor analgesia with ropivacaine.

Thyen AB, McAllister RK, Councilman LM. J Patient Saf. 2010;6:244-246.

STUDY

Critical incident reports concerning anaesthetic equipment: analysis of the UK National Reporting and Learning System (NRLS) data from 2006-2008.

Cassidy CJ, Smith A, Arnot-Smith J. Anaesthesia. 2011;66:879-888.

COMMENTARY

Shortage of perioperative drugs: implications for anesthesia practice and patient safety.

De Oliveira GS Jr, Theilken LS, McCarthy RJ. Anesth Analg. 2011;113:1429-1435.

STUDY

The impact of perioperative catastrophes on anesthesiologists: results of a national survey.

Gazoni FM, Amato PE, Malik ZM, Durieux ME. Anesth Analg. 2012;114:596-603.

STUDY

Deconstructing intraoperative communication failures.

Hu YY, Arriaga AF, Peyre SE, Corso KA, Roth EM, Greenberg CC. J Surg Res. 2012;177:37-42.

STUDY

Compliance with guidelines to prevent surgical site infections: as simple as 1-2-3?

Meeks DW, Lally KP, Carrick MM, et al. Am J Surg. 2011;201:76-83.

STUDY

Disorganized care: the findings of an iterative, in-depth analysis of surgical morbidity and mortality.

Anderson CI, Nelson CS, Graham CF, et al. J Surg Res. 2012;177:43-48.

COMMENTARY

Practice advisory on anesthetic care for magnetic resonance imaging: a report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging.

Anesthesiology. 2009;110:459-479.

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