AHRQ Patient Safety Network

The Collection > Error Analysis

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Safety Target

•Device-related Complications (24)

•Diagnostic Errors (71)

•Identification Errors (17)

•Discontinuities, Gaps, and Hand-Off Problems (64)

•Fatigue and Sleep Deprivation (8)

•Medication Safety (254)

•Medical Complications (63)

•Nonsurgical Procedural Complications (14)

•Surgical Complications (89)

•Transfusion Complications (4)

•Psychological and Social Complications (25)

Origin/Sponsor

•Asia (20)

•Australia and New Zealand (38)

•Central and South America (3)

Resource Types

•Journal Article (649)

•Legislation/Regulation (4)

•Meeting/Conference (1)

•Newspaper/Magazine Article (37)

•Press Release/Announcement (1)

•Special or Theme Issue (9)

•Tools/Toolkit (9)

•Web Resource (7)

Error Types

•Epidemiology of Errors and Adverse Events (382)

•Active Errors (96)

•Latent Errors (65)

•Near Miss (19)

Approach to Improving Safety
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Error Analysis

•Root Cause Analysis (53)

•Failure Mode Effects Analysis (30)

•Morbidity and Mortality Conferences (14)

•Narrative/Storytelling (11)

Clinical Areas

•Allied Health Services (3)

Target Audience

•Health Care Providers (429)

•Health Care Executives and Administrators (609)

•Non-Health Care Professionals (244)

•Patients (28)

Setting of Care

•Hospitals (478)

•Psychiatric Facilities (5)

•Residential Facilities (13)

•Ambulatory Care (79)

•Outpatient Surgery (7)

•Patient Transport (7)

1 - 20 of 757

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STUDY

What do hospital staff in the UK think are the causes of penicillin medication errors?

Wilcock M, Harding G, Moore L, Nicholls I, Powell N, Stratton J. Int J Clin Pharm. 2013;35:72-78.

STUDY

Supratherapeutic dosing of acetaminophen among hospitalized patients.

Zhou L, Maviglia SM, Mahoney LM, et al. Arch Intern Med. 2012;172:1721-1728.

STUDY

An observational study of the frequency, severity, and etiology of failures in postoperative care after major elective general surgery.

Symons NR, Almoudaris AM, Nagpal K, Vincent CA, Moorthy K. Ann Surg. 2013;257:1-5.

REVIEW

Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review.

Lawton R, McEachan RRC, Giles SJ, Sirriyeh R, Watt IS, Wright J. BMJ Qual Saf. 2012;21:369-380.

STUDY

Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study.

Hogan H, Healey F, Neale G, Thomson R, Vincent C, Black N. BMJ Qual Saf. 2012;21:737-745.

STUDY

Multiple component patient safety intervention in English hospitals: controlled evaluation of second phase.

Benning A, Dixon-Woods M, Nwulu U, et al. BMJ. 2011;342:d199.

COMMENTARY

Deaths due to medical error: jumbo jets or just small propeller planes?

Shojania KG. BMJ Qual Saf. 2012;21:709-712.

STUDY

Challenges and opportunities to prevent transfusion errors: a Qualitative Evaluation for Safer Transfusion (QUEST).

Heddle NM, Fung M, Hervig T, et al; BEST Collaborative. Transfusion. 2012;52:1687-1695.

STUDY

The costs of adverse drug events in community hospitals.

Hug BL, Keohane C, Seger DL, Yoon C, Bates DW. Jt Comm J Qual Patient Saf. 2012;38:120-126.

REVIEW

Understanding factors that impact on health care professionals' risk perceptions and responses toward Clostridium difficile and methicillin-resistant Staphylococcus aureus: a structured literature review.

Burnett E, Kearney N, Johnston B, Corlett J, Macgillivray S. Am J Infect Control. 2013;41:394-400.

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.

STUDY

Triangulating case-finding tools for patient safety surveillance: a cross-sectional case study of puncture/laceration.

Taylor JA, Gerwin D, Morlock L, Miller MR. Inj Prev. 2011;17:388-393.

STUDY

Adverse drug events caused by serious medication administration errors.

Kale A, Keohane CA, Maviglia S, Gandhi TK, Poon EG. BMJ Qual Saf. 2012;21:933-938.

REVIEW

Improving patient safety through the systematic evaluation of patient outcomes.

Forster AJ, Dervin G, Martin C, Papp S. Can J Surg. 2012;55:418-425.

STUDY

Policy and practice in the use of root cause analysis to investigate clinical adverse events: mind the gap.

Nicolini D, Waring J, Mengis J. Soc Sci Med. 2011;73:217-225.

NEWSPAPER/MAGAZINE ARTICLE

Events associated with the prescribing, dispensing, and administering of medication loading doses.

Carson SL, Gaunt MJ. PA-PSRS Patient Saf Advis. 2012;9:82-88.

COMMENTARY

Using the opportunity estimator tool to improve engagement in a quality and safety intervention.

Duval-Arnould J, Mathews SC, Weeks K, et al. Jt Comm J Qual Patient Saf. 2012;38:41-47.

STUDY

Identifying the latent failures underpinning medication administration errors: an exploratory study.

Lawton R, Carruthers S, Gardner P, Wright J, McEachan RR. Health Serv Res. 2012;47:1437-1459.

REVIEW

Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis.

Royal S, Smeaton L, Avery AJ, Hurwitz B, Sheikh A. Qual Saf Health Care. 2006;15:23-31.

STUDY

Prevalence of error-prone abbreviations used in medication prescribing for hospitalised patients: multi-hospital evaluation.

Dooley MJ, Wiseman M, Gu G. Intern Med J. 2012;42:e19-e22.

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