AHRQ Patient Safety Network

The Collection > United States of America

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Safety Target

•Device-related Complications (190)

•Diagnostic Errors (137)

•Identification Errors (113)

•Discontinuities, Gaps, and Hand-Off Problems (403)

•Fatigue and Sleep Deprivation (100)

•Medication Safety (1006)

•Medical Complications (412)

•Nonsurgical Procedural Complications (67)

•Surgical Complications (292)

•Transfusion Complications (16)

•Psychological and Social Complications (119)

Origin/Sponsor
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United States of America

•United States Federal Government (209)

•State Governments and Agencies (35)

Resource Types

•Clinical Guideline (6)

•Journal Article (2291)

•Legislation/Regulation (49)

•Meeting/Conference (26)

•Newsletter/Journal (6)

•Newspaper/Magazine Article (596)

•Press Release/Announcement (23)

•Special or Theme Issue (53)

•Tools/Toolkit (57)

•Web Resource (89)

•Grant (7)

Error Types

•Epidemiology of Errors and Adverse Events (663)

•Active Errors (600)

•Latent Errors (243)

•Near Miss (58)

Approach to Improving Safety

•Quality Improvement Strategies (890)

•Legal and Policy Approaches (482)

•Error Reporting and Analysis (1046)

•Communication Improvement (788)

•Human Factors Engineering (418)

•Teamwork (233)

•Specialization of Care (248)

•Logistical Approaches (301)

•Culture of Safety (582)

•Technologic Approaches (643)

•Education and Training (660)

Clinical Areas

•Allied Health Services (10)

Target Audience

•Health Care Providers (2260)

•Health Care Executives and Administrators (2808)

•Non-Health Care Professionals (1341)

•Patients (387)

Setting of Care

•Hospitals (2462)

•Psychiatric Facilities (11)

•Residential Facilities (60)

•Ambulatory Care (315)

•Outpatient Surgery (39)

•Patient Transport (19)

1 - 20 of 3536

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NEWSPAPER/MAGAZINE ARTICLE

Proper positioning of pharmacy label on Hospira PCA vials will avoid interference with scanning.

ISMP Medication Safety Alert! Acute Care Edition. August 14, 2008;13:1-3.

COMMENTARY

Preparing your hospital for compliance with The Joint Commission's National Patient Safety Goals.

Murdaugh L, Jordin R. Hosp Pharm. 2008;43:728-733.

AWARD RECIPIENT

The MacArthur Fellows Program: Eric Coleman.

The John D. and Catherine T. MacArthur Foundation. October 3, 2012.

STUDY

Excess cost and length of stay associated with voluntary patient safety event reports in hospitals.

Paradis AR, Stewart VT, Bayley KB, Brown A, Bennett AJ. Am J Med Qual. 2009;24:53-60.

COMMENTARY

Financial incentives to promote health care quality: the hospital acquired conditions nonpayment policy.

Kavanagh KT. Soc Work Public Health. 2011;26:524-541.

BOOK/REPORT

Second Victim: Error, Guilt, Trauma, and Resilience.

Dekker S. Boca Raton, FL: CRC Press; 2013. ISBN: 9781466583412.

SPECIAL OR THEME ISSUE

Journal of Quality Improvement in Healthcare, Second Edition.

Heilman J, ed. Albuquerque, NM: University of New Mexico; May 2013.

COMMENTARY

Human cognition and the dynamics of failure to rescue: the Lewis Blackman case.

Acquaviva K, Haskell H, Johnson J. J Prof Nurs. 2013;29:95-101.

STUDY

A survey of the impact of disruptive behaviors and communication defects on patient safety.

Rosenstein AH, O'Daniel M. Jt Comm J Qual Patient Saf. 2008;34:464-471.

COMMENTARY

Disclosing medical mistakes: a communication management plan for physicians.

Petronio S, Torke A, Bosslet G, Isenberg S, Wocial L, Helft PR. Perm J. 2013;17:73-79.

ORGANIZATIONAL POLICY/GUIDELINES

Leadership committed to safety.

Sentinel Event Alert. August 27, 2009;(43):1-3.

STUDY

Association between hospital-reported Leapfrog Safe Practices scores and inpatient mortality.

Kernisan LP, Lee SJ, Boscardin WJ, Landefeld CS, Dudley RA. JAMA. 2009;301:1341-1348.

NEWSPAPER/MAGAZINE ARTICLE

'Alarm fatigue’ a factor in 2nd death.

Kowalczyk L. Boston Globe. September 21, 2011.

STUDY

Evaluation of a nurse-led safety program in a critical care unit.

Saladino L, Pickett LC, Frush K, Mall A, Champagne MT. J Nurs Care Qual. 2013;28:139-146.

NEWSPAPER/MAGAZINE ARTICLE

Do you hold staff accountable for safety?

Terry K. Hosp Health Netw. February 2010.

STUDY

Slow progress on meeting hospital safety standards: learning from the Leapfrog Group's efforts.

Moran J, Scanlon D. Health Aff (Millwood). 2013;32:27-35.

COMMENTARY

Anatomy of an incident disclosure: the importance of dialogue.

Iedema R, Allen S. Jt Comm J Qual Patient Saf. 2012;38:435-442.

COMMENTARY classic

Balancing "no blame" with accountability in patient safety.

Wachter RM, Pronovost PJ. N Engl J Med. 2009;361:1401-1406.

COMMENTARY

Hospital board checklist to improve culture and reduce central line–associated bloodstream infections.

Goeschel CA, Holzmueller CG, Pronovost PJ. Jt Comm J Qual Patient Saf. 2010;36:525-528.

COMMENTARY

Improving heparin safety: a multidisciplinary invited conference.

Peterson C, Ham CW, Vanderveen T. Hosp Pharm. 2008;43:491-497.

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