AHRQ Patient Safety Network

The Collection > Nurses

PATIENT SAFETY PRIMERS
Nursing and Patient Safety

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Safety Target

•Device-related Complications (48)

•Diagnostic Errors (8)

•Identification Errors (28)

•Discontinuities, Gaps, and Hand-Off Problems (101)

•Fatigue and Sleep Deprivation (19)

•Medication Safety (339)

•Medical Complications (81)

•Nonsurgical Procedural Complications (17)

•Surgical Complications (103)

•Transfusion Complications (3)

•Psychological and Social Complications (22)

Origin/Sponsor

•Asia (24)

•Australia and New Zealand (35)

•Central and South America (3)

Resource Types

•Clinical Guideline (5)

•Journal Article (729)

•Legislation/Regulation (14)

•Meeting/Conference (2)

•Newsletter/Journal (3)

•Newspaper/Magazine Article (69)

•Press Release/Announcement (8)

•Special or Theme Issue (15)

•Tools/Toolkit (15)

•Web Resource (11)

Error Types

•Epidemiology of Errors and Adverse Events (143)

•Active Errors (117)

•Latent Errors (53)

•Near Miss (21)

Approach to Improving Safety

•Quality Improvement Strategies (230)

•Legal and Policy Approaches (32)

•Error Reporting and Analysis (186)

•Communication Improvement (218)

•Human Factors Engineering (119)

•Teamwork (101)

•Specialization of Care (44)

•Logistical Approaches (105)

•Culture of Safety (120)

•Technologic Approaches (125)

•Education and Training (167)

Clinical Areas

•Allied Health Services (3)

•Medicine (483)

•Nursing (482)

•Pharmacy (76)

Target Audience
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Nurses

Setting of Care

•Hospitals (581)

•Psychiatric Facilities (5)

•Residential Facilities (18)

•Ambulatory Care (39)

•Outpatient Surgery (4)

•Patient Transport (4)

1 - 20 of 892

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STUDY

A multicenter, phased, cluster-randomized controlled trial to reduce central line–associated bloodstream infections in intensive care units.

Marsteller JA, Sexton JB, Hsu YJ, et al. Crit Care Med. 2012;40:2933-2939.

REVIEW

Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients.

Johnson JR, Kuskowski MA, Wilt TJ. Ann Intern Med. 2006;144:116-126.

COMMENTARY

2009 National Patient Safety Goals.

Saufl NM. J Perianesth Nurs. 2009;24:114-118.

NEWSPAPER/MAGAZINE ARTICLE

Patients taking their own medications while in the hospital.

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

STUDY

An overview of intravenous-related medication administration errors as reported to MEDMARX^(R), a national medication error-reporting program.

Hicks RW, Becker SC. J Infus Nurs. 2006;29:20-27.

STUDY

Adherence to simple and effective measures reduces the incidence of ventilator-associated pneumonia: [L'observation de mesures simples et efficaces reduit l'incidence de pneumonie associee a la ventilation mecanique].

Baxter AD, Allan J, Bedard J, et al. Can J Anaesth. 2005;52:535-541.

STUDY

Nursing care quality and adverse events in US hospitals.

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

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.

ORGANIZATIONAL POLICY/GUIDELINES

Tubing misconnections—a persistent and potentially deadly occurrence.

Sentinel Event Alert. April 3, 2006;(36):1-3.

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

Increasing vigilance on the medical/surgical floor to improve patient safety.

Jacobs JL, Apatov N, Glei M. J Adv Nurs. 2007;57:472-481.

NEWSPAPER/MAGAZINE ARTICLE

Dose of technology helps Shands at UF avoid drug errors.

Chun D. Gainsville Sun. August 21, 2006.

NEWSPAPER/MAGAZINE ARTICLE

What pilots can teach hospitals about patient safety.

Murphy K. New York Times. October 31, 2006:F5.

COMMENTARY

Creating high reliability in health care organizations.

Pronovost PJ, Berenholtz SM, Goeschel CA, et al. Health Serv Res. 2006;41:1599-1617.

STUDY

Relationship between systems-level factors and hand hygiene adherence.

Dunn-Navarra AM, Cohen B, Stone PW, Pogorzelska M, Jordan S, Larson E. J Nurs Care Qual. 2011;26:30-38.

REVIEW

Tubing misconnections: normalization of deviance.

Simmons D, Symes L, Guenter P, Graves K. Nutr Clin Pract. 2011;26:286-293.

COMMENTARY

Smart pumps: implications for nurse leaders.

Kirkbride G, Vermace B. Nurs Adm Q. 2011;35:110-118.

COMMENTARY

Pharmacy–nursing intervention to improve accuracy and completeness of medication histories.

Tessier EG, Henneman EA, Nathanson B, Plotkin K, Heelon M. Am J Health Syst Pharm. 2010;67:607-611.

REVIEW

Failure mode and effects analysis application to critical care medicine.

Duwe B, Fuchs BD, Hansen-Flaschen J. Crit Care Clin. 2005;21:21-30, vii.

STUDY

Barriers and facilitators to nursing handoffs: recommendations for redesign.

Welsh CA, Flanagan ME, Ebright P. Nurs Outlook. 2010;58:148-154.

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