AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (117)

•Diagnostic Errors (118)

•Identification Errors (84)

•Discontinuities, Gaps, and Hand-Off Problems (268)

•Fatigue and Sleep Deprivation (44)

•Medication Safety (779)

•Medical Complications (300)

•Nonsurgical Procedural Complications (74)

•Surgical Complications (324)

•Transfusion Complications (13)

•Psychological and Social Complications (65)

Origin/Sponsor

•Australia and New Zealand (79)

•Central and South America (8)

•Europe (364)

•North America (1842)

Resource Types

•Audiovisual (9)

•Book/Report (71)

•Clinical Guideline (3)

•Journal Article (1995)

•Legislation/Regulation (29)

•Meeting/Conference (13)

•Newsletter/Journal (3)

•Newspaper/Magazine Article (127)

•Press Release/Announcement (14)

•Special or Theme Issue (24)

•Tools/Toolkit (19)

•Web Resource (40)

Error Types

•Epidemiology of Errors and Adverse Events (747)

•Active Errors (436)

•Latent Errors (136)

•Near Miss (51)

Approach to Improving Safety

•Quality Improvement Strategies (591)

•Legal and Policy Approaches (113)

•Error Reporting and Analysis (687)

•Communication Improvement (541)

•Human Factors Engineering (374)

•Teamwork (228)

•Specialization of Care (181)

•Logistical Approaches (166)

•Culture of Safety (275)

•Technologic Approaches (465)

•Education and Training (454)

Clinical Areas

•Allied Health Services (6)

•Dentistry (4)

•Medicine (1678)

•Nursing (263)

•Pharmacy (259)

Target Audience
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Quality and Safety Professionals

Setting of Care

•Hospitals (1569)

•Psychiatric Facilities (6)

•Residential Facilities (37)

•Ambulatory Care (173)

•Outpatient Surgery (22)

•Patient Transport (18)

1 - 20 of 2358

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STUDY

Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study.

Morriss FH Jr, Abramowitz PW, Nelson SP, et al. J Pediatr. 2009;197:678-685.

STUDY

Prevalence of adverse events in pediatric intensive care units in the United States.

Agarwal S, Classen D, Larsen G, et al. Pediatr Crit Care Med. 2010;11:568-578.

STUDY

Toward learning from patient safety reporting systems.

Pronovost PJ, Thompson DA, Holzmueller CG, et al. J Crit Care. 2006;21:305-315.

STUDY

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Association of ICU or hospital admission with unintentional discontinuation of medications for chronic diseases.

Bell CM, Brener SS, Gunraj N, et al. JAMA. 2011;306:840-847.

STUDY

Identifying causes of adverse events detected by an automated trigger tool through in-depth analysis.

Muething SE, Conway PH, Kloppenborg E, et al. Qual Saf Health Care. 2010;19:435-439.

STUDY

Comparing errors in ED computer-assisted vs conventional pediatric drug dosing and administration.

Yamamoto L, Kanemori J. Am J Emerg Med. 2010;28:588-592.

NEWSPAPER/MAGAZINE ARTICLE

Another tragic parenteral nutrition compounding error.

ISMP Medication Safety Alert! Acute Care Edition. April 21, 2011;16:1-3.

STUDY

Statewide NICU central-line–associated bloodstream infection rates decline after bundles and checklists.

Schulman J, Stricof R, Stevens TP, et al; New York State Regional Perinatal Care Centers. Pediatrics. 2011;127:436-444.

NEWSPAPER/MAGAZINE ARTICLE

Medication errors occurring with the use of bar-code administration technology.

PA-PSRS Patient Saf Advis. December 2008;5:122-126.

STUDY

NICU medication errors: identifying a risk profile for medication errors in the neonatal intensive care unit.

Stavroudis TA, Shore AD, Morlock L, Hicks RW, Bundy D, Miller MR. J Perinatol. 2010;30:459-468.

STUDY

Iatrogenic events resulting in intensive care admission: frequency, cause, and disclosure to patients and institutions.

Lehmann LS, Puopolo AL, Shaykevich S, Brennan TA. Am J Med. 2005;118:409-413.

STUDY

Direct observation approach for detecting medication errors and adverse drug events in a pediatric intensive care unit.

Buckley MS, Erstad BL, Kopp BJ, Theodorou AA, Priestley G. Pediatr Crit Care Med. 2007;8:145-152.

STUDY

Specialty-based, voluntary incident reporting in neonatal intensive care: description of 4846 incident reports.

Snijders C, van Lingen RA, Klip H, Fetter WP, van der Schaaf TW, Molendijk HA, NEOSAFE study group. Arch Dis Child Fetal Neonatal Ed. 2009;94:F210-F215.

STUDY

Pediatric safety incidents from an intensive care reporting system.

Skapik JL, Pronovost PJ, Miller MR, Thompson DA, Wu AW. J Patient Saf. 2009;5:95-101.

STUDY

Adverse drug event reporting in intensive care units: a survey of current practices.

Kane-Gill SL, Devlin JW. Ann Pharmacother. 2006;40:1267-73.

STUDY

A comparison of voluntarily reported medication errors in intensive care and general care units.

Kane-Gill SL, Kowiatek JG, Weber RJ. Qual Saf Health Care. 2010;19:55-59.

REVIEW

Computerized physician order entry in the critical care environment: a review of current literature.

Maslove DM, Rizk N, Lowe HJ. J Intensive Care Med. 2011;26:165-171.

STUDY

classic

Effect of bar-code technology on the safety of medication administration.

Poon EG, Keohane CA, Yoon CS, et al. N Engl J Med. 2010;362:1698-1707.

STUDY

Outpatient adverse drug events identified by screening electronic health records.

Gandhi TK, Seger AC, Overhage JM, et al. J Patient Saf. 2010;6;91-96.

STUDY

Adverse drug events in a paediatric intensive care unit: a prospective cohort.

Silva DCB, Araujo OR, Arduini RG, Alonso CFR, Shibata ARO, Troster EJ. BMJ Open. 2013;3:ee001868.

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