This AHRQ-funded analysis of patient safety research found that research output—as measured by federal grant funding and peer-reviewed publications—increased sharply between 1995 and 2014. Publication of the To Err Is Human report and passage of federal budget stimulus funds were associated with an increase in patient safety publications and research funding.

… Am J Health Syst Pharm … Am J Health-Syst Pharm … Pharmacists can play an important role …

Administration of parental nutrition is a specialized process that requires distinct competencies to be safe. This guideline recommends standardized competencies for clinicians to develop and maintain to ensure safe and reliable administration of parenteral nutrition therapy in various care environments and team configurations.

Shortages of medications and compounding components can lead to diversion from recommended treatment. This review describes problems that can arise due to shortages in parenteral nutrition components. The authors recommend strategies to reduce risks associated with lack of ingredients for parenteral nutrition.

This study describes errors associated with parenteral nutrition submitted to the Institute for Safe Medication Practices Medication Errors Reporting Program. The majority of errors occurred during the compounding or dispensing and administration stages.

Enteral nutrition is provided to patients in a variety of care settings, and errors in the enteral nutrition–use process may lead to safety hazards. Drawing from current evidence, these consensus guidelines recommend best practices to ensure safety of enteral nutrition, including a six-step standardized approach to administering eternal nutrition that involves independent double-checks and automation with forcing functions.

Physicians have become more comfortable with recognizing and disclosing errors to patients in the past few decades, but speaking up about a peer's error remains challenging. Discussing a case involving a surgeon discovering a serious mistake made by a colleague, this commentary provides insights from surgical and bioethics experts on how to address the situation.

Previous studies have explored safety issues related to parenteral nutrition processes, but problems associated with general nutrition for inpatients have received scant attention. This commentary advocates for promoting awareness around malnutrition as a hospital-acquired condition and outlines 12 actions to improve the safety of nutrition care for hospitalized patients, including use of routine assessments and checklists.

Parenteral nutrition has the potential to result in patient harm if administered or prepared incorrectly. This commentary builds on a set of overarching recommendations to define competencies that enable the safe prescribing and delivery of parenteral nutrition. The model is designed to help organizations apply the suggestions in their particular care environments.

Redesigning tubing connectors according to new ISO standards has the potential to reduce tubing misconnections. This commentary provides information about changes to enteral connectors to prepare clinicians to use the new devices in their organizations.

This commentary describes strategies to promote the use of parenteral nutrition safety guidelines in practice. The authors include examples of how checklists can improve adoption of best practices and discuss the potential for instituting policies and providing information about drug shortages to drive integration of the recommendations into daily work.

… International Society of Oncology Pharmacy Practitioners … J Oncol Pharm Pract … A fatal chemotherapy medication error …

… JPEN J Parenter Enteral Nutr … JPEN J Parenter Enteral Nutr … This … associated with parenteral nutrition . … Ayers P, Adams S, Boullata J, et al. A.S.P.E.N. parenteral nutrition safety consensus recommendations.  …

… JPEN. Journal of parenteral and enteral nutrition … JPEN J Parenter Enteral Nutr … Finding a 5% overall pharmacist …

Analyzing published case studies on tubing misconnections and expert recommendations for improvement, this review suggests that equipment redesign—making enteral and IV systems incompatible—is the most effective strategy to reduce incidence of such errors.