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PATIENT SAFETY PRIMERS
Never Events
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TOOLS/TOOLKIT
Introduction to Trigger Tools for Identifying Adverse Events.
Institute for Healthcare Improvement.
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.
NEWSPAPER/MAGAZINE ARTICLE
USP initiatives for the safe use of medical gases.
Zaidi K, Curry PD Jr, Becker SC. Pharmaceutical Technology. November 2, 2005;29:102-103.
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
Technological methods used to prevent errors aren't infallible.
Santell JP. Mater Manage Health Care. December 19, 2006;15:26-28, 30.
NEWSPAPER/MAGAZINE ARTICLE
Mistakes, some deadly, haunt county jails.
Carter M. Seattle Times. March 9, 2007:A1.
STUDY
Drug errors and related interventions reported by United States clinical pharmacists: The American College of Clinical Pharmacy Practice-Based Research Network medication error detection, amelioration and prevention study.
Kuo GM, Touchette DR, Marinac JS; American College of Clinical Pharmacy Practice-Based Research Network Collaborative. Pharmacotherapy. 2013;33:253-265.
STUDY
Medication errors and response bias: the tip of the iceberg.
Bar-Oz B, Goldman M, Lahat E, et al. Isr Med Assoc J. 2008;10:771-774.
STUDY
Rate, causes and reporting of medication errors in Jordan: nurses' perspectives.
Mrayyan MT, Shishani K, Al-Faouri I. J Nurs Manag. Sep 2007;15:659-670.
STUDY
Medication safety program reduces adverse drug events in a community hospital.
Cohen MM, Kimmel NL, Benage MK, et al. Qual Saf Health Care. 2005;14:169-174.
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 event reporting in intensive care units: a survey of current practices.
Kane-Gill SL, Devlin JW. Ann Pharmacother. 2006;40:1267-73.
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
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
Anatomy of a patient safety event: a pediatric patient safety taxonomy.
Woods DM, Johnson J, Holl JL, et al. Qual Saf Health Care. 2005;14:422-427.
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.
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