The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.
Dager WE, Ansell J, Barnes GD, et al. Jt Comm J Qual Saf. 2020;46:173-180.
The Joint Commission previously issued a sentinel event alert for medication errors relating to anticoagulant therapies and included them as part of the National Patient Safety Goal (NPSG) program. This commentary discusses the eight 2019 NPSGs for anticoagulants: dosing protocols; anticoagulant reversal; perioperative management; laboratory monitoring; anticoagulant safety; patient education; unit dose packaging, and; programmable pumps.
Levy AG, Scherer AM, Zikmund-Fisher BJ, et al. JAMA Netw Open. 2018;1:e185293.
Diagnostic errors and delays may occur when patients fail to disclose medically relevant information. This study analyzed online survey responses from 4510 patients and found that about 70% reported not disclosing information. Disagreement with a clinician's recommendation or failure to understand a clinician's instructions were common. Patients most often did not disclose because they feared judgment from the clinician or felt embarrassed.