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Urine a Tough Position.
Gandhi TK. AHRQ WebM&M [serial online]. October 2003.
Switched urine specimens lead to a patient receiving the wrong answer about her pregnancy test.
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Resource Type
Commentary
Setting of Care
Ambulatory Clinic or Office
Target Audience
Health Care Providers
Non-Health Care Professionals
Patients
Clinical Area
Family Medicine
Primary Care
General Internal Medicine
Safety Target
Diagnostic Errors
Wrong Patient
Psychological and Social Complications
Missed or Critical Lab Results
Error Types
Epidemiology of Errors and Adverse Events
Noncognitive Errors ("Slips & Lapses")
Latent Errors
Approach to Improving Safety
Practice Guidelines
Institutional Reporting
Failure Mode Effects Analysis
Provider-Patient Communication
Laboratory Result Tracking Improvement
Bar Coding and Radiofrequency ID Tagging
Origin/Sponsor
Agency for Healthcare Research and Quality (AHRQ)