AHRQ Patient Safety Network

The Collection > Quality and Safety Professionals

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Safety Target

•Device-related Complications (107)

•Diagnostic Errors (92)

•Identification Errors (80)

•Discontinuities, Gaps, and Hand-Off Problems (252)

•Fatigue and Sleep Deprivation (50)

•Medication Safety (674)

•Medical Complications (253)

•Nonsurgical Procedural Complications (67)

•Surgical Complications (274)

•Transfusion Complications (10)

•Psychological and Social Complications (63)

Origin/Sponsor

•Asia (25)

•Australia and New Zealand (57)

•Central and South America (3)

•Europe (234)

•North America (1761)

Resource Types

•Audiovisual (10)

•Award (5)

•Book/Report (67)

•Clinical Guideline (3)

•Journal Article (1766)

•Legislation/Regulation (28)

•Meeting/Conference (10)

•Newsletter/Journal (3)

•Newspaper/Magazine Article (129)

•Press Release/Announcement (11)

•Special or Theme Issue (24)

•Tools/Toolkit (21)

•Web Resource (31)

•Grant (3)

Error Types

•Epidemiology of Errors and Adverse Events (567)

•Active Errors (372)

•Latent Errors (139)

•Near Miss (42)

Approach to Improving Safety

•Quality Improvement Strategies (527)

•Legal and Policy Approaches (105)

•Error Reporting and Analysis (599)

•Communication Improvement (515)

•Human Factors Engineering (393)

•Teamwork (218)

•Specialization of Care (157)

•Logistical Approaches (170)

•Culture of Safety (268)

•Technologic Approaches (399)

•Education and Training (417)

Clinical Areas

•Allied Health Services (6)

Target Audience
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Quality and Safety Professionals

Setting of Care

•Hospitals (1454)

•Psychiatric Facilities (6)

•Residential Facilities (32)

•Ambulatory Care (146)

•Outpatient Surgery (19)

•Patient Transport (15)

1 - 20 of 2111

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NEWSPAPER/MAGAZINE ARTICLE

Medication errors: a year in review.

Institute for Safe Medication Practices. Pharmacy Practice News. October 2011:7-14.

REVIEW

The safety of intravenous drug delivery systems: update on current issues since the 1999 Consensus Development Conference.

Sanborn M, Gabay M, Moody ML. Hosp Pharm. 2009;44:159-164.

NEWSPAPER/MAGAZINE ARTICLE

Dose of technology helps Shands at UF avoid drug errors.

Chun D. Gainsville Sun. August 21, 2006.

NEWSPAPER/MAGAZINE ARTICLE

Don't underestimate the impact of change on risk potential.

ISMP Medication Safety Alert! Acute Care Edition. September 11, 2008;13:1-3.

COMMENTARY

Medication tracers: a systems approach to medication safety.

Hendrick EC, Montanya KR, Griffith N. Hosp Pharm. 2007;42:916-920.

BOOK/REPORT

Fluorouracil Incident Root Cause Analysis Report.

Toronto, ON, Canada: Institute for Safe Medication Practices Canada. May 8, 2007.

ORGANIZATIONAL POLICY/GUIDELINES

ASHP statement on bar-code verification during inventory, preparation, and dispensing of medications.

Am J Health Syst Pharm. 2011;68:442-445.

NEWSPAPER/MAGAZINE ARTICLE

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

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

COMMENTARY

ISMP medication error report analysis.

Cohen MR, Smetzer JL. Hosp Pharm. 2010;45:13-17.

AUDIOVISUAL PRESENTATION

When things go wrong.

Institute for Healthcare Improvement. Campaign Live. August 18, 2008.

STUDY

Severity of medication administration errors detected by a bar-code medication administration system.

Sakowski J, Newman JM, Dozier K. Am J Health Syst Pharm. 2008;65:1661-1666.

STUDY

Improving the usability of intravenous medication labels to support safe medication delivery.

Bauer DT, Guerlain S. Int J Ind Ergon. 2011;41:394-399.

COMMENTARY

ISMP medication error report analysis.

Cohen MR, Smetzer JL. Hosp Pharm. 2010;45:191-195.

COMMENTARY

ISMP medication error report analysis.

Cohen MR. Hosp Pharm. 2009;44:654-657.

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.

NEWSPAPER/MAGAZINE ARTICLE

Guidelines for timely medication administration: response to the CMS "30-minute rule."

ISMP Medication Safety Alert! Acute Care Edition. January 13, 2011;16:1-4.

COMMENTARY

Implementation of a specialized pharmacy team to monitor high-risk medications during discharge.

Martin ES III, Overstreet RL, Jackson-Khalil LR, McCollough HL, Meyer TA, Xu Q. Am J Health Syst Pharm. 2013;70:18-21.

NEWSPAPER/MAGAZINE ARTICLE

Results of ISMP survey on high-alert medications: differences between nursing, pharmacy, and risk/quality/safety perspectives.

ISMP Medication Safety Alert! Acute Care Edition. February 9, 2012;17:1-4.

REVIEW

Bar code technology and medication administration error.

Young J, Slebodnik M, Sands L. J Patient Saf. 2010;6;115-120.

STUDY

Strategic work-arounds to accommodate new technology: the case of smart pumps in hospital care.

McAlearney AS, Vrontos J Jr, Schneider PJ, Curran CR, Czerwinski BS, Pedersen CA. J Patient Saf. 2007;3:75-81.

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