AHRQ Patient Safety Network

The Collection > Quality and Safety Professionals

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Safety Target

•Device-related Complications (109)

•Diagnostic Errors (84)

•Identification Errors (73)

•Discontinuities, Gaps, and Hand-Off Problems (222)

•Fatigue and Sleep Deprivation (29)

•Medication Safety (581)

•Medical Complications (261)

•Nonsurgical Procedural Complications (64)

•Surgical Complications (376)

•Transfusion Complications (10)

•Psychological and Social Complications (57)

Origin/Sponsor

•Africa (2)

•Asia (43)

•Australia and New Zealand (94)

•Central and South America (6)

•Europe (431)

•North America (1352)

Resource Types

•Audiovisual (6)

•Award (6)

•Book/Report (56)

•Clinical Guideline (3)

•Journal Article (1658)

•Legislation/Regulation (24)

•Meeting/Conference (11)

•Newsletter/Journal (2)

•Newspaper/Magazine Article (89)

•Press Release/Announcement (13)

•Special or Theme Issue (30)

•Tools/Toolkit (17)

•Web Resource (33)

•Grant (4)

Error Types

•Epidemiology of Errors and Adverse Events (536)

•Active Errors (393)

•Latent Errors (123)

•Near Miss (47)

Approach to Improving Safety

•Quality Improvement Strategies (492)

•Legal and Policy Approaches (88)

•Error Reporting and Analysis (509)

•Communication Improvement (504)

•Human Factors Engineering (406)

•Teamwork (236)

•Specialization of Care (129)

•Logistical Approaches (139)

•Culture of Safety (243)

•Technologic Approaches (330)

•Education and Training (382)

Clinical Areas

•Allied Health Services (5)

Target Audience
< All

Quality and Safety Professionals

Setting of Care

•Hospitals (1321)

•Psychiatric Facilities (8)

•Residential Facilities (32)

•Ambulatory Care (134)

•Outpatient Surgery (23)

•Patient Transport (17)

1 - 20 of 1952

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REVIEW

Human factors in surgery: from Three Mile Island to the operating room.

D'Addessi A, Bongiovanni L, Volpe A, Pinto F, Bassi P. Urol Int. 2009;83:249-257.

STUDY

Interruptions and miscommunications in surgery: an observational study.

Gillespie BM, Chaboyer W, Fairweather N. AORN J. 2012;95:576-590.

STUDY

Causes of near misses: perceptions of perioperative nurses.

Cohoon B. AORN J. 2011;93:551-565.

STUDY

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.

Wauben LS, Dekker-van Doorn CM, van Wijngaarden JD, et al. Int J Qual Health Care. 2011;23:159-166.

STUDY

Adherence to a medication safety protocol: current practice for labeling medications and solutions on the sterile field.

Brown-Brumfield D, DeLeon A. AORN J. 2010;91:610-617.

STUDY

The impact of organisational and individual factors on team communication in surgery: a qualitative study.

Gillespie BM, Chaboyer W, Longbottom P, Wallis M. Int J Nurs Stud. 2010;47:732-741.

STUDY

Using simulation training to improve perioperative patient safety.

Mullen L, Byrd D. AORN J. 2013;97:419-427.

COMMENTARY

Communication in the perioperative setting.

Cvetic E. AORN J. 2011;94:261-270.

STUDY

Incorrect surgical counts: a qualitative analysis.

Rowlands A, Steeves R. AORN J. 2010;92:410-419.

REVIEW

Enhancing communication in surgery through team training interventions: a systematic literature review.

Gillespie BM, Chaboyer W, Murray P. AORN J. 2010;92:642-657.

COMMENTARY

Unintended transplantation of three organs from an HIV-positive donor: report of the analysis of an adverse event in a regional health care service in Italy.

Bellandi T, Albolino S, Tartaglia R, Filipponi F. Transplant Proc. 2010;42:2187-2189.

STUDY

Use of failure mode and effects analysis for proactive identification of communication and handoff failures from organ procurement to transplantation.

Steinberger DM, Douglas SV, Kirschbaum MS. Prog Transplant. 2009;19:208-215.

STUDY

Team communication during patient handover from the operating room: more than facts and figures.

Manser T, Foster S, Flin R, Patey R. Hum Factors. 2013;55:138-156.

COMMENTARY

Increasing patient safety and surgical team communication by using a count/time out board.

Edel EM. AORN J. 2010;92:420-424.

STUDY

Differential impact of a crew resource management program according to professional specialty.

Suva D, Haller G, Lübbeke A, Hoffmeyer P. Am J Med Qual. 2012;27:313-320.

STUDY

Continuous monitoring of adverse events: influence on the quality of care and the incidence of errors in general surgery.

Rebasa P, Mora L, Luna A, Montmany S, Vallverdú H, Navarro S. World J Surg. 2009;33:191-198.

COMMENTARY

Reducing surgical complications.

Griffin FA. Jt Comm J Qual Patient Saf. 2007;33:660-665.

ORGANIZATIONAL POLICY/GUIDELINES

AORN Guidance Statement: Safe Medication Practices in Perioperative Settings Across the Life Span.

AORN J. 2006;84:276-278, 280-283.

COMMENTARY

Instrument readiness: an important link to patient safety.

McNamara SA. AORN J. 2011;93:160-164.

COMMENTARY

Surgical team training: promoting high reliability with nontechnical skills.

Paige JT. Surg Clin North Am. 2010;90:569-581.

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