AHRQ Patient Safety Network

The Collection > United States of America

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Safety Target

•Device-related Complications (147)

•Diagnostic Errors (159)

•Identification Errors (141)

•Discontinuities, Gaps, and Hand-Off Problems (340)

•Fatigue and Sleep Deprivation (85)

•Medication Safety (1128)

•Medical Complications (353)

•Nonsurgical Procedural Complications (82)

•Surgical Complications (507)

•Transfusion Complications (16)

•Psychological and Social Complications (102)

Origin/Sponsor
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United States of America

•United States Federal Government (135)

•State Governments and Agencies (24)

Resource Types

•Audiovisual (46)

•Award (7)

•Book/Report (105)

•Clinical Guideline (7)

•Journal Article (2368)

•Legislation/Regulation (46)

•Meeting/Conference (14)

•Newsletter/Journal (4)

•Newspaper/Magazine Article (361)

•Press Release/Announcement (22)

•Special or Theme Issue (27)

•Tools/Toolkit (34)

•Web Resource (53)

•Grant (2)

Error Types

•Epidemiology of Errors and Adverse Events (1038)

•Active Errors (624)

•Latent Errors (179)

•Near Miss (71)

Approach to Improving Safety

•Quality Improvement Strategies (688)

•Legal and Policy Approaches (270)

•Error Reporting and Analysis (978)

•Communication Improvement (712)

•Human Factors Engineering (439)

•Teamwork (227)

•Specialization of Care (198)

•Logistical Approaches (248)

•Culture of Safety (324)

•Technologic Approaches (576)

•Education and Training (555)

Clinical Areas

•Allied Health Services (10)

Target Audience

•Health Care Providers (2157)

•Health Care Executives and Administrators (2485)

•Non-Health Care Professionals (1010)

•Patients (247)

Setting of Care

•Hospitals (1984)

•Psychiatric Facilities (7)

•Residential Facilities (56)

•Ambulatory Care (288)

•Outpatient Surgery (41)

•Patient Transport (24)

1 - 20 of 3096

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COMMENTARY

Use of an anatomic marking form as an alternative to the Universal Protocol for Preventing Wrong Site, Wrong Procedure and Wrong Person Surgery.

Knight N, Aucar J. Am J Surg. 2010;200:803-807.

STUDY

Preventing wrong site, procedure, and patient events using a common cause analysis.

Mallett R, Conroy M, Saslaw LZ, Moffatt-Bruce S. Am J Med Qual. 2012;27:21-29.

STUDY

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?

Seiden SC, Barach P. Arch Surg. 2006;141:931-939.

REVIEW

Avoiding wrong site surgery: a systematic review.

DeVine J, Chutkan N, Norvell DC, Dettori JR. Spine. 2010;35(suppl 9):S28-S36.

STUDY

Wrong-site craniotomy: analysis of 35 cases and systems for prevention.

Cohen FL, Mendelsohn D, Bernstein M. J Neurosurg. 2010;113:461-473.

STUDY

Medication error reporting in nursing homes: identifying targets for patient safety improvement.

Greene SB, Williams CE, Pierson S, Hansen RA, Carey TS. Qual Saf Health Care. 2010;19:218-222.

STUDY

Operating room briefings and wrong-site surgery.

Makary MA, Mukherjee A, Sexton BJ, et al. J Am Coll Surg. 2007;204:236-243.

STUDY

Variation in surgical time-out and site marking within pediatric otolaryngology.

Shah RK, Arjmand E, Roberson DW, Deutsch E, Derkay C. Arch Otolaryngol Head Neck Surg. 2011;137:69-73.

STUDY

Eight-year experience with a neurosurgical checklist.

Lyons MK. Am J Med Qual. 2010;25:285-288.

REVIEW

Spinal surgery and patient safety: a systems approach.

Wong DA. J Am Acad Orthop Surg. 2006;14:226-232.

STUDY

Process changes to increase compliance with the Universal Protocol for bedside procedures.

Barsuk JH, Brake H, Caprio T, Barnard C, Anderson DY, Williams MV. Arch Intern Med. 2011;171:947-949.

REVIEW

Prevention of 3 "never events" in the operating room: fires, gossypiboma, and wrong-site surgery.

Zahiri HR, Stromberg J, Skupsky H, et al. Surg Innov. 2011;18:55-60.

STUDY

Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis of a prospective database of physician self-reported occurrences.

Stahel PF, Sabel AL, Victoroff MS, et al. Arch Surg. 2010;145:978-984.

STUDY

Wrong-site sinus surgery in otolaryngology.

Shah RK, Nussenbaum B, Kienstra M, et al. Otolaryngol Head Neck Surg. 2010;143:37-41.

STUDY

Application of human error theory in case analysis of wrong procedures.

Duthie EA. J Patient Saf. 2010;6:108-114.

STUDY

Incorrect surgical procedures within and outside of the operating room.

Neily J, Mills PD, Eldridge N, et al. Arch Surg. 2009;144:1028-1034.

STUDY

Quality improvement project to reduce perioperative opioid oversedation events in a paediatric hospital.

Vermaire D, Caruso MC, Lesko A, et al. BMJ Qual Saf. 2011;20:895-902.

STUDY

Incorrect surgical procedures within and outside of the operating room: a follow-up report.

Neily J, Mills PD, Eldridge N, et al. Arch Surg. 2011;146 1235-1239.

BOOK/REPORT

Annual Benchmarking Report: Malpractice Risks in Surgery.

Cambridge, MA: CRICO/RMF Strategies; 2010.

STUDY

An intervention to decrease patient identification band errors in a children's hospital.

Hain PD, Joers B, Rush M, et al. Qual Saf Health Care. 2010;19:244-247.

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