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Seven hundred and fifty-nine (759) chances to learn: a 3-year pilot project to analyse transfusion-related near-miss events in the Republic of Ireland.
Lundy D, Laspina S, Kaplan H, et al. Seven hundred and fifty-nine (759) chances to learn: a 3-year pilot project to analyse transfusion-related near-miss events in the Republic of Ireland. Vox Sang. 2007;92(3):233-41.
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August 10, 2011
Lundy D, Laspina S, Kaplan H, et al. Vox Sang. 2007;92(3):233-41.
The researchers analyzed transfusion-related near-miss data and found that near misses occur more frequently than adverse events causing harm. They conclude that near-miss data are a useful tool for identifying human and system failures and targeting improvements.
