AHRQ Patient Safety Network

The Collection > Anticoagulants

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Anticoagulants

Origin/Sponsor

•Australia and New Zealand (2)

•Central and South America (1)

Resource Types

•Clinical Guideline (1)

•Journal Article (49)

•Legislation/Regulation (1)

•Newspaper/Magazine Article (18)

•Press Release/Announcement (2)

•Tools/Toolkit (1)

•Web Resource (1)

Error Types

•Epidemiology of Errors and Adverse Events (24)

•Active Errors (24)

•Latent Errors (8)

•Near Miss (1)

Approach to Improving Safety

•Quality Improvement Strategies (20)

•Legal and Policy Approaches (7)

•Error Reporting and Analysis (26)

•Communication Improvement (16)

•Human Factors Engineering (22)

•Specialization of Care (17)

•Logistical Approaches (6)

•Technologic Approaches (28)

•Education and Training (10)

Clinical Areas

•Medicine (64)

•Nursing (6)

•Pharmacy (33)

Target Audience

•Health Care Providers (60)

•Health Care Executives and Administrators (49)

•Non-Health Care Professionals (9)

•Patients (10)

Setting of Care

•Hospitals (57)

•Residential Facilities (6)

•Ambulatory Care (6)

•Outpatient Surgery (1)

1 - 20 of 76

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STUDY

Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts.

Miller AM, Boro MS, Korman NE, Davoren JB. J Am Med Inform Assoc. 2011;18(suppl 1):i45-i50.

STUDY

Anticoagulation-associated adverse drug events.

Piazza G, Nguyen TN, Cios D, et al. Am J Med. 2011;124:1136-1142.

STUDY

Patterns in nursing home medication errors: disproportionality analysis as a novel method to identify quality improvement opportunities.

Hansen RA, Cornell PY, Ryan PB, Williams CE, Pierson S, Greene SB. Pharmacoepidemiol Drug Saf. 2010;19:1087-1094.

COMMENTARY

Unreported errors in the intensive care unit: a case study of the way we work.

Henneman EA. Crit Care Nurse. 2007;27:27-34.

STUDY

Emergency department visits for outpatient adverse drug events: demonstration for a national surveillance system.

Budnitz DS, Pollock DA, Mendelsohn AB, Weidenbach KN, McDonald AK, Annest JL. Ann Emerg Med. 2005;45:197-206.

MEASUREMENT TOOL/INDICATOR

2005 ISMP Medication Safety Self Assessment® for Antithrombotic Therapy in Hospitals.

Huntingdon Valley, PA: Institute for Safe Medication Practices; 2005.

NEWSPAPER/MAGAZINE ARTICLE

Common cause analysis.

Clapper C, Crea K. Patient Saf Qual Healthc. May/June 2010;7:30-35.

STUDY

The safety of warfarin therapy in the nursing home setting.

Gurwitz JH, Field TS, Radford MJ, et al. Am J Med. 2007;120:539-544.

NEWSPAPER/MAGAZINE ARTICLE

Action needed to prevent dangerous heparin-insulin confusion.

ISMP Medication Safety Alert! Acute Care Edition. May 3, 2007;12:1-2.

STUDY

Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy.

Waitman LR, Phillips IE, McCoy AB, et al. Jt Comm J Qual Patient Saf. 2011;37:326-332.

COMMENTARY

Improving heparin safety: a multidisciplinary invited conference.

Peterson C, Ham CW, Vanderveen T. Hosp Pharm. 2008;43:491-497.

STUDY

Racial disparities in the frequency of patient safety events: results from the National Medicare Patient Safety Monitoring System.

Metersky ML, Hunt DR, Kliman R, et al. Med Care. 2011;49:504-510.

STUDY

Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance.

Classen DC, Jaser L, Budnitz DS. Jt Comm J Qual Patient Saf. 2010;36:12-21, AP1-AP9.

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.

STUDY

Patient reported receipt of medication instructions for warfarin is associated with reduced risk of serious bleeding events.

Metlay JP, Hennessy S, Localio AR, et al. J Gen Intern Med. 2008;23:1589-1594.

NEWSPAPER/MAGAZINE ARTICLE

Heparin overdose in three infants revisits hospital error issues.

Phend C. MedPage Today. November 26, 2007.

STUDY

Use of specific indicators to detect warfarin-related adverse events.

Hartis CE, Gum MO, Lederer JW Jr. Am J Health Syst Pharm. 2005;62:1683-1688.

STUDY

Clinical and safety impact of an inpatient pharmacist-directed anticoagulation service.

Schillig J, Kaatz S, Hudson M, Krol GD, Szandzik EG, Kalus JS. J Hosp Med. 2011;6:322-328.

MULTI-USE WEBSITE

National Patient Safety Goals.

Oakbrook Terrace, IL: The Joint Commission; 2011.

ORGANIZATIONAL POLICY/GUIDELINES

Preventing errors relating to commonly used anticoagulants.

Sentinel Event Alert. September 24, 2008;(41):1-4.

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