AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (2)

•Diagnostic Errors (7)

•Identification Errors (8)

•Discontinuities, Gaps, and Hand-Off Problems (19)

•Fatigue and Sleep Deprivation (3)

•Medication Safety (88)

•Medical Complications (22)

•Nonsurgical Procedural Complications (5)

•Surgical Complications (22)

•Transfusion Complications (1)

•Psychological and Social Complications (15)

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United Kingdom

Resource Types

•Audiovisual (2)

•Book/Report (45)

•Journal Article (220)

•Legislation/Regulation (1)

•Meeting/Conference (2)

•Newspaper/Magazine Article (16)

•Press Release/Announcement (1)

•Special or Theme Issue (14)

•Tools/Toolkit (2)

•Web Resource (5)

Error Types

•Epidemiology of Errors and Adverse Events (64)

•Active Errors (40)

•Latent Errors (15)

•Near Miss (5)

Approach to Improving Safety

•Quality Improvement Strategies (92)

•Legal and Policy Approaches (29)

•Error Reporting and Analysis (103)

•Communication Improvement (58)

•Human Factors Engineering (40)

•Teamwork (30)

•Specialization of Care (14)

•Logistical Approaches (7)

•Culture of Safety (58)

•Technologic Approaches (58)

•Education and Training (66)

Clinical Areas

•Allied Health Services (1)

•Medicine (186)

•Nursing (8)

•Pharmacy (29)

Target Audience

•Health Care Providers (178)

•Health Care Executives and Administrators (276)

•Non-Health Care Professionals (188)

•Patients (21)

Setting of Care

•Hospitals (161)

•Psychiatric Facilities (2)

•Residential Facilities (1)

•Ambulatory Care (26)

•Outpatient Surgery (1)

•Patient Transport (3)

1 - 20 of 308

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REVIEW

What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?

Schedlbauer A, Prasad V, Mulvaney C, et al. J Am Med Inform Assoc. 2009;16:531-538.

STUDY

Methodological variability in detecting prescribing errors and consequences for the evaluation of interventions.

Franklin BD, Birch S, Savage I, et al. Pharmacoepidemiol Drug Saf. 2009;18:992-999.

REVIEW

Prescribing errors in hospital practice.

Tully MP. Br J Clin Pharmacol. 2012;74:668-675.

STUDY

Stakeholder challenges in purchasing medical devices for patient safety.

Hinrichs S, Dickerson T, Clarkson J. J Patient Saf. 2013;9:36-43.

STUDY

Improving general practice computer systems for patient safety: qualitative study of key stakeholders.

Avery AJ, Savelyich BSP, Sheikh A, Morris CJ, Bowler I, Teasdale S. Qual Saf Health Care. 2007;16:28-33.

REVIEW

Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence.

Keers RN, Williams SD, Cooke J, Ashcroft DM. Ann Pharmacother. 2013;47:237-256.

STUDY

The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.

Franklin BD, O'Grady K, Donyai P, Jacklin A, Barber N. Qual Saf Health Care. 2007;16:279-284.

STUDY

Pharmacists' interventions in prescribing errors at hospital discharge: an observational study in the context of an electronic prescribing system in a UK teaching hospital.

Abdel-Qader DH, Harper L, Cantrill JA, Tully MP. Drug Saf. 2010;33:1027-1044.

BOOK/REPORT

Information Design for Patient Safety: A Guide to the Graphic Design of Medication Packaging. 2nd edition.

London, England: The Helen Hamlyn Research Centre and the National Patient Safety Agency; 2007.

STUDY

Paediatric dosing errors before and after electronic prescribing.

Jani YH, Barber N, Wong ICK. Qual Saf Health Care. 2010;19:337-340.

STUDY

A prospective hazard and improvement analytic approach to predicting the effectiveness of medication error interventions.

Karnon J, McIntosh A, Dean J, et al. Safety Sci. 2007;45:523-539.

STUDY

Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors.

Scott GPT, Shah P, Wyatt JC, Makubate B, Cross FW. J Am Med Inform Assoc. 2011;18:789-798.

STUDY

Can an electronic prescribing system detect doctors who are more likely to make a serious prescribing error?

Coleman JJ, Hemming K, Nightingale PG, et al. J R Soc Med. 2011;104:208-218.

STUDY

Medication errors: a prospective cohort study of hand-written and computerised physician order entry in the intensive care unit.

Shulman R, Singer M, Goldstone J, Bellingan G. Crit Care. 2005;9:R516-R521.

NEWSPAPER/MAGAZINE ARTICLE

NHS drug error 'crackdown' urged.

BBC News. August 11, 2006.

STUDY

Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study.

Ramnarayan P, Roberts GC, Coren M, et al. BMC Med Inform Decis Mak. 2006;6:22.

REVIEW

National efforts to improve health information system safety in Canada, the United States of America and England.

Kushniruk AW, Bates DW, Bainbridge M, Househ MS, Borycki EM. Int J Med Inform. 2013;82:e149-e160.

REVIEW

What have we learned about interventions to reduce medical errors?

Woodward HI, Mytton OT, Lemer C, et al. Annu Rev Public Health. 2010;31:479-497.

STUDY

Perceived causes of prescribing errors by junior doctors in hospital inpatients: a study from the PROTECT programme.

Ross S, Ryan C, Duncan EM, et al. BMJ Qual Saf. 2013;22:97-102.

STUDY

Organisational readiness: exploring the preconditions for success in organisation-wide patient safety improvement programmes.

Burnett S, Benn J, Pinto A, Parand A, Iskander S, Vincent C. Qual Saf Health Care. 2010;19:313-317.

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