AHRQ Patient Safety Network

The Collection > Error Analysis

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Safety Target

•Device-related Complications (29)

•Diagnostic Errors (92)

•Identification Errors (17)

•Discontinuities, Gaps, and Hand-Off Problems (62)

•Fatigue and Sleep Deprivation (11)

•Medication Safety (254)

•Medical Complications (49)

•Nonsurgical Procedural Complications (19)

•Surgical Complications (93)

•Transfusion Complications (4)

•Psychological and Social Complications (26)

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•Asia (15)

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•Journal Article (680)

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•Newspaper/Magazine Article (48)

•Press Release/Announcement (6)

•Special or Theme Issue (8)

•Tools/Toolkit (7)

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Error Types

•Epidemiology of Errors and Adverse Events (311)

•Active Errors (115)

•Latent Errors (64)

•Near Miss (17)

Approach to Improving Safety
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Error Analysis

•Root Cause Analysis (70)

•Failure Mode Effects Analysis (43)

•Morbidity and Mortality Conferences (15)

•Narrative/Storytelling (11)

Clinical Areas

•Allied Health Services (1)

Target Audience

•Health Care Providers (505)

•Health Care Executives and Administrators (650)

•Non-Health Care Professionals (233)

•Patients (32)

Setting of Care

•Hospitals (444)

•Psychiatric Facilities (3)

•Residential Facilities (14)

•Ambulatory Care (67)

•Outpatient Surgery (3)

•Patient Transport (6)

1 - 20 of 799

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STUDY

Intralipid medication errors in the neonatal intensive care unit.

Chuo J, Lambert G, Hicks RW. Jt Comm J Qual Patient Saf. 2007;33:104-111.

NEWSPAPER/MAGAZINE ARTICLE

Medication administration in anesthesia: time for a paradigm shift.

Stabile M, Webster CS, Merry AF. APSF Newsletter. Fall 2007;22:44-47.

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.

STUDY

Child-specific risk factors and patient safety.

Woods DM, Holl JL, Shonkoff JP, Mehra M, Ogata ES, Weiss KB. J Patient Saf. 2005;1:17-22.

NEWSPAPER/MAGAZINE ARTICLE

Medical simulations identify potential problems before they can pose a real threat.

Kleefeld E. Wisconsin Technology Network. June 15, 2005.

STUDY

Computer based medication error reporting: insights and implications.

Miller MR, Clark JS, Lehmann CU. Qual Saf Health Care. 2006;15:208-213.

STUDY

The "Big Dog" effect: variability assessing the causes of error in diagnoses of patients with lung cancer.

Raab SS, Meier FA, Zarbo RJ, et al. J Clin Oncol. 2006;24:2808-2814.

STUDY

Time of day effects on the incidence of anesthetic adverse events.

Wright MC, Phillips-Bute B, Mark JB, et al. Qual Saf Health Care. 2006;15:258-263.

STUDY

Review of the Australian Incident Monitoring System.

Spigelman AD, Swan J. ANZ J Surg. 2005;75:657-661.

STUDY

Outside case review of surgical pathology for referred patients: the impact on patient care.

Swapp RE, Aubry MC, Salomão DR, Cheville JC. Arch Pathol Lab Med. 2013;137:233-240.

STUDY

Decreasing errors in pediatric continuous intravenous infusions.

Lehmann CU, Kim GR, Gujral R, Veltri MA, Clark JS, Miller MR. Pediatr Crit Care Med. 2006;7:225-230.

COMMENTARY

Appropriate prescribing of medications: an eight-step approach.

Pollock M, Bazaldua OV, Dobbie AE. Am Fam Physician. 2007;75:231-236, 239-240.

STUDY

Copying and pasting of examinations within the electronic medical record.

Thielke S, Hammond K, Helbig S. Int J Med Inform. 2007;76(suppl 1):122-28.

STUDY

Potential medication dosing errors in outpatient pediatrics.

McPhillips HA, Stille CJ, Smith D, et al. J Pediatr. 2005;147:761-767.

STUDY

Drug-induced hypoglycaemia--new insight into an old problem.

Ching CK, Lai CK, Poon WT, et al. Hong Kong Med J. 2006;12:334-338.

NEWSPAPER/MAGAZINE ARTICLE

Practitioners agree on medication reconciliation value, but frustration and difficulties abound.

ISMP Medication Safety Alert! Acute Care Edition. July 13, 2006;11:1-2.

STUDY

Potential utility of data-mining algorithms for early detection of potentially fatal/disabling adverse drug reactions: a retrospective evaluation.

Hauben M, Reich L. J Clin Pharmacol. 2005;45:378-384.

STUDY

Retained surgical items: a problem yet to be solved.

Stawicki SP, Moffatt-Bruce SD, Ahmed HM, et al. J Am Coll Surg. 2013;216:15-22.

STUDY

Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program.

Kiran RP, Ahmed Ali U, Coffey JC, Vogel JD, Pokala N, Fazio VW. Ann Surg. 2012;256:469-475.

NEWSPAPER/MAGAZINE ARTICLE

Building a case for medication reconciliation.

Nurse Advise-ERR. April 2006;4:1-3.

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