AHRQ Patient Safety Network

The Collection > Critical Pathways

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Safety Target

•Device-related Complications (9)

•Diagnostic Errors (4)

•Identification Errors (7)

•Discontinuities, Gaps, and Hand-Off Problems (9)

•Medication Safety (17)

•Medical Complications (13)

•Nonsurgical Procedural Complications (5)

•Surgical Complications (17)

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•Book/Report (2)

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•Epidemiology of Errors and Adverse Events (20)

•Active Errors (22)

•Latent Errors (5)

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Approach to Improving Safety
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Critical Pathways

Clinical Areas

•Medicine (57)

•Nursing (14)

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Target Audience

•Health Care Providers (54)

•Health Care Executives and Administrators (53)

•Non-Health Care Professionals (20)

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Setting of Care

•Hospitals (53)

•Ambulatory Care (1)

•Outpatient Surgery (3)

•Patient Transport (2)

1 - 20 of 62

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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.

STUDY

Reduction of central line infections in Veterans Administration intensive care units: an observational cohort using a central infrastructure to support learning and improvement.

Render ML, Hasselbeck R, Freyberg RW, Hofer TP, Sales AE, Almenoff PL; VA ICU Clinical Advisory Group. BMJ Qual Saf. 2011;20:725-732.

STUDY

The ability of intensive care units to maintain zero central line–associated bloodstream infections.

Lipitz-Snyderman A, Needham DM, Colantuoni E, et al. Arch Intern Med. 2011;171:856-858.

BOOK/REPORT

Eliminating CLABSI: A National Patient Safety Imperative.

Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-0037-1-EF.

STUDY

Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit.

Berenholtz SM, Pham JC, Thompson DA, et al. Infect Control Hosp Epidemiol. 2011;32:305-314.

STUDY

Trauma resuscitation errors and computer-assisted decision support.

Fitzgerald M, Cameron P, Mackenzie C, et al. Arch Surg. 2011;146:218-225.

COMMENTARY

Central Line Clot.

Randolph AG. AHRQ WebM&M [serial online]. May 2003.

STUDY

Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections.

Jain R, Kralovic SM, Evans ME, et al. N Engl J Med. 2011;364:1419-1430.

NEWSPAPER/MAGAZINE ARTICLE

Another tragic parenteral nutrition compounding error.

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

STUDY

Evaluating an evidence-based bundle for preventing surgical site infection.

Anthony T, Murray BW, Sum-Ping JT, et al. Arch Surg. 2011;146:263-269.

NEWSPAPER/MAGAZINE ARTICLE

Ferrari's Formula One handovers and handovers from surgery to intensive care.

Sower VE, Duffy JA, Kohers G. American Society for Quality. August 2008.

STUDY

Impact of a comprehensive patient safety strategy on obstetric adverse events.

Pettker CM, Thung SF, Norwitz ER, et al. Am J Obstet Gynecol. 2009 May;200:492.e1-8.

STUDY

Reducing inappropriate diagnostic practice through education and decision support.

Bairstow PJ, Persaud J, Mendelson R, Nguyen L. Int J Qual Health Care. 2010;22:194-200.

REVIEW

Systematic review of safety checklists for use by medical care teams in acute hospital settings—limited evidence of effectiveness.

Ko HCH, Turner TJ, Finnigan MA. BMC Health Serv Res. 2011;11:211.

STUDY

Utilizing improvement science methods to improve physician compliance with proper hand hygiene.

White CM, Statile AM, Conway PH, et al. Pediatrics. 2012;129:e1042-e1050.

STUDY

Identifying opportunities for quality improvement in surgical site infection prevention.

Gagliardi AR, Eskicioglu C, McKenzie M, Fenech D, Nathens A, McLeod R. Am J Infect Control. 2009;37:398-402.

STUDY

Prevention of intravenous drug incompatibilities in an intensive care unit.

Bertsche T, Mayer Y, Stahl R, et al. Am J Health Syst Pharm. 2008;65:1834-1840.

COMMENTARY

Implementing a systematic response to medication errors.

Larsen D, Cole R, Higton P. Nurs Stand. 2007;21:35-40.

STUDY

Outcome of 6 years of protocol use for preventing wrong site office surgery.

Starling J 3rd, Coldiron BM. J Am Acad Dermatol. 2011;65:807-810.

COMMENTARY

A Mid-Summer Fog

Braddock CH. AHRQ WebM&M [serial online]. November 2008.

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