AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (146)

•Diagnostic Errors (95)

•Identification Errors (82)

•Discontinuities, Gaps, and Hand-Off Problems (360)

•Fatigue and Sleep Deprivation (98)

•Medication Safety (868)

•Medical Complications (365)

•Nonsurgical Procedural Complications (56)

•Surgical Complications (352)

•Transfusion Complications (16)

•Psychological and Social Complications (92)

Origin/Sponsor

•Africa (2)

•Asia (49)

•Australia and New Zealand (52)

•Central and South America (7)

•Europe (228)

•North America (2452)

Resource Types

•Audiovisual (33)

•Award (17)

•Book/Report (124)

•Clinical Guideline (4)

•Journal Article (2086)

•Legislation/Regulation (37)

•Meeting/Conference (11)

•Newspaper/Magazine Article (402)

•Press Release/Announcement (7)

•Special or Theme Issue (15)

•Tools/Toolkit (33)

•Web Resource (44)

•Grant (1)

Error Types

•Epidemiology of Errors and Adverse Events (967)

•Active Errors (409)

•Latent Errors (189)

•Near Miss (53)

Approach to Improving Safety

•Quality Improvement Strategies (653)

•Legal and Policy Approaches (273)

•Error Reporting and Analysis (809)

•Communication Improvement (614)

•Human Factors Engineering (342)

•Teamwork (186)

•Specialization of Care (227)

•Logistical Approaches (283)

•Culture of Safety (346)

•Technologic Approaches (472)

•Education and Training (509)

Clinical Areas

•Allied Health Services (4)

•Medicine (2007)

•Nursing (393)

•Pharmacy (318)

Target Audience

•Health Care Providers (1929)

•Health Care Executives and Administrators (2126)

•Non-Health Care Professionals (878)

•Patients (256)

Setting of Care
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Hospitals

•General Hospitals (729)

•Children’s Hospitals (85)

•Specialty Hospitals (30)

1 - 20 of 2814

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STUDY

Excess dosing of antiplatelet and antithrombin agents in the treatment of non–ST-segment elevation acute coronary syndromes.

Alexander KP, Chen AY, Roe MT, et al; CRUSADE Investigators. JAMA. 2005;294:3108-3116.

STUDY

Drug-induced hypoglycaemia--new insight into an old problem.

Ching CK, Lai CK, Poon WT, et al. Hong Kong Med J. 2006;12:334-338.

ORGANIZATIONAL POLICY/GUIDELINES

Safe use of opioids in hospitals.

Sentinel Event Alert. August 8, 2012;(49):1-5.

COMMENTARY

IV medication safety software implementation in a multihospital health system.

Cassano AT. Hosp Pharm. 2006;41:151-156.

STUDY

Avoiding handover fumbles: a controlled trial of a structured handover tool versus traditional handover methods.

Payne CE, Stein JM, Leong T, Dressler DD. BMJ Qual Saf. 2012;21:925-932.

COMMENTARY

Best-practice protocols: Preventing adverse drug events.

Weir VL. Nurs Manage. 2005;36:24-30.

STUDY

An alternative strategy for studying adverse events in medical care.

Andrews LB, Stocking C, Krizek T, et al. Lancet. 1997;349:309-313.

COMMENTARY

Intravenous medication safety and smart infusion systems: lessons learned and future opportunities.

Keohane CA, Hayes J, Saniuk C, Rothschild JM, Bates DW. J Infus Nurs. 2005;28:321-328.

STUDY

The impact of traditional and smart pump infusion technology on nurse medication administration performance in a simulated inpatient unit.

Trbovich PL, Pinkney S, Cafazzo JA, Easty AC. Qual Saf Health Care. 2010;19:430-434.

STUDY

Reducing interruptions to improve medication safety.

Freeman R, McKee S, Lee-Lehner B, Pesenecker J. J Nurs Care Qual. 2013;28:176-185.

STUDY

Potassium and phosphorus repletion in hospitalized patients: implications for clinical practice and the potential use of healthcare information technology to improve prescribing and patient safety.

Hemstreet BA, Stolpman N, Badesch DB, May SK, McCollum M. Curr Med Res Opin. 2006;22:2449-2455.

STUDY

Intralipid medication errors in the neonatal intensive care unit.

Chuo J, Lambert G, Hicks RW. Jt Comm J Qual Patient Saf. 2007;33:104-111.

STUDY

Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accuracy.

Kliger J, Blegen MA, Gootee D, O'Neil E. Jt Comm J Qual Patient Saf. 2009;35:604-612.

STUDY

Opportunities for performance improvement in relation to medication administration during pediatric stabilization.

Morgan N, Luo X, Fortner C, Frush K. Qual Saf Health Care. 2006;15:179-183.

STUDY

Adverse drug events caused by serious medication administration errors.

Kale A, Keohane CA, Maviglia S, Gandhi TK, Poon EG. BMJ Qual Saf. 2012;21:933-938.

NEWSPAPER/MAGAZINE ARTICLE

Patients taking their own medications while in the hospital.

PA-PSRS Patient Saf Advis. June 2012;9:50-57.

STUDY

Medical emergency team calls in the radiology department: patient characteristics and outcomes.

Ott LK, Pinsky MR, Hoffman LA, et al. BMJ Qual Saf. 2012 Mar 2; [Epup ahead of print].

STUDY

Nursing care quality and adverse events in US hospitals.

Lucero RJ, Lake ET, Aiken LH. J Clin Nurs. 2010;19:2185-2195.

STUDY

Adverse drug events in hospitalized cardiac patients.

Fanikos J, Cina JL, Baroletti S, Fiumara K, Matta L, Goldhaber SZ. Am J Cardiol. 2007;100:1465-1469.

STUDY

Designing for distractions: a human factors approach to decreasing interruptions at a centralised medication station.

Colligan L, Guerlain S, Steck SE, Hoke TR. BMJ Qual Saf. 2012;21:939-947.

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