AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (18)

•Identification Errors (3)

•Discontinuities, Gaps, and Hand-Off Problems (34)

•Medication Safety (348)

•Medical Complications (8)

•Nonsurgical Procedural Complications (1)

•Surgical Complications (4)

Origin/Sponsor

•Australia and New Zealand (11)

•Central and South America (3)

•North America (288)

Resource Types

•Audiovisual (5)

•Book/Report (8)

•Clinical Guideline (1)

•Journal Article (257)

•Legislation/Regulation (9)

•Newspaper/Magazine Article (64)

•Press Release/Announcement (2)

•Special or Theme Issue (1)

•Tools/Toolkit (5)

•Web Resource (1)

Error Types

•Epidemiology of Errors and Adverse Events (129)

•Active Errors (79)

•Latent Errors (24)

•Near Miss (6)

Approach to Improving Safety

•Quality Improvement Strategies (57)

•Legal and Policy Approaches (17)

•Error Reporting and Analysis (64)

•Communication Improvement (86)

•Human Factors Engineering (70)

•Teamwork (3)

•Specialization of Care (85)

•Logistical Approaches (24)

•Culture of Safety (15)

•Technologic Approaches (175)

•Education and Training (45)

Clinical Areas
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Hospital Pharmacy

Target Audience

•Health Care Providers (271)

•Health Care Executives and Administrators (251)

•Non-Health Care Professionals (98)

•Patients (12)

Setting of Care

•Hospitals (335)

•Psychiatric Facilities (1)

•Ambulatory Care (6)

•Outpatient Surgery (2)

1 - 20 of 354

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NEWSPAPER/MAGAZINE ARTICLE

Medication errors: when pharmacy is closed.

PA-PSRS Patient Saf Advis. March 2012;9:11-17.

STUDY

Inter-rater reliability of a classification system for hospital adverse drug event reports.

Haynes K, Hennessy S, Morales KH, et al. Clin Pharmacol Ther. 2008;83:485-488.

STUDY

Nurses relate the contributing factors involved in medication errors.

Tang FI, Sheu SJ, Yu S, Wei IL, Chen CH. J Clin Nurs. 2007;16:447-457.

STUDY

The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use.

Page RL 2nd, Ruscin JM. Am J Geriatr Pharmacother. 2006;4:297-305.

STUDY

Reliability evaluation of the adapted National Coordinating Council Medication Error Reporting and Prevention (NCC MERP) index.

Snyder RA, Abarca J, Meza JL, Rothschild JM, Rizos A, Bates DW. Pharmacoepidemiol Drug Saf. 2007:16:1006-1013.

STUDY

Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients.

Holdsworth MT, Fichtl RE, Raisch DW, et al. Pediatrics. 2007;120:1058-1066.

STUDY

Internal reporting system to improve a pharmacy's medication distribution process.

Rickrode GA, Williams-Lowe ME, Rippe JL, Theriault RH Jr. Am J Health Syst Pharm. 2007;64:1197-1202.

STUDY

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration—2011.

Pedersen CA, Schneider PJ, Scheckelhoff DJ. Am J Health Syst Pharm. 2012;69:768-785.

STUDY

Reporting trends in a regional medication error data-sharing system.

Anderson JG, Ramanujam R, Hensel DJ, Sirio CA. Health Care Manag Sci. 2010;13:74-83.

STUDY

Cost implications of actual and potential adverse events prevented by interventions of a critical care pharmacist.

Kopp BJ, Mrsan M, Erstad BL, Duby JJ. Am J Health Syst Pharm. 2007;64:2483-2487.

REVIEW

Systematic review of medication safety assessment methods.

Meyer-Massetti C, Cheng CM, Schwappach DL, et al. Am J Health Syst Pharm. 2011;68:227-240.

STUDY

Effect of patient- and medication-related factors on inpatient medication reconciliation errors.

Salanitro AH, Osborn CY, Schnipper JL, et al. J Gen Intern Med. 2012;27:924-932.

STUDY

Frequency of HIV-related medication errors and associated risk factors in hospitalized patients.

Pastakia SD, Corbett AH, Raasch RH, Napravnik S, Correll TA. Ann Pharmacother. 2008;42:491-497.

STUDY

Medication-error reporting and pharmacy resident experience during implementation of computerized prescriber order entry.

Weant KA, Cook AM, Armitstead JA. Am J Health Syst Pharm. 2007;64:526-530.

STUDY

Rural inpatient telepharmacy consultation demonstration for after-hours medication review.

Cole SL, Grubbs JH, Din C, Nesbitt TS. Telemed E Health. 2012;18:530-537.

REVIEW

"Tech-check-tech": a review of the evidence on its safety and benefits.

Adams AJ, Martin SJ, Stolpe SF. Am J Health Syst Pharm. 2011;68:1824-1833.

STUDY

Impact of a pharmacotherapy alerting system on medication errors.

Natali BJ, Varkey AC, Garey KW, Liebl M. Am J Health Syst Pharm. 2013;70:48-52.

STUDY

classic

Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial.

Kripalani S, Roumie CL, Dalal AK, et al; PILL-CVD (Pharmacist Intervention for Low Literacy in Cardiovascular Disease) Study Group. Ann Intern Med. 2012;157:1-10.

NEWSPAPER/MAGAZINE ARTICLE

A shortage of everything except errors: harm associated with drug shortages.

ISMP Medication Safety Alert! Acute Care Edition. April 19, 2012;17:1-3.

NEWSPAPER/MAGAZINE ARTICLE

Supplementary Advisory: Results of the PA-PSRS Workgroup on Pharmacy Computer System Safety.

PA-PSRS Patient Saf Advis. May 2007;4(suppl 2):1-8.

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