Diagnostic errors remain a major healthcare concern. This study was a retrospective record review of 882 pediatric intensive care unit (PICU) patients to identify diagnostic errors using the Revised Safer Dx tool. Diagnostic errors were found in 13 (1.5%) patients, most commonly associated with atypical presentation and diagnostic uncertainty at admission.

In this retrospective review of ambulatory care infection prevention and control (IPC) breaches reported to state health departments, the authors observed 5% rate of breaches and found that common breaches involved sterilization and disinfection of reusable devices, device reprocessing, and IPC infrastructure. These and other breaches highlight opportunities for additional training, leadership oversight, and resource investment.

Errors in medication preparation and administration can lead to patient harm. Examining the evidence on intravenous preparation errors in hospitals, this systematic review suggests that there is significant opportunity to improve the intravenous medication preparation process.

The concept of "number needed to treat" is used to quantify the number of patients who would need to undergo therapy to prevent one adverse clinical outcome. This study of opioid prescribing in an academic emergency department found that prescribers had to view more than 123 unnecessary alerts to prevent one adverse drug event. Studies such as this help quantify the number needed to treat for computerized warnings, a critical step forward in understanding and mitigating alert fatigue.

Crushing pills or capsules is sometimes necessary when a patient is not capable of swallowing normally, but this can also be a source of medication errors. This study, conducted in a university hospital in Germany, demonstrated a significant reduction in inappropriate crushing of medications after an intensive educational program.

A quality improvement program successfully reduced the incidence of medication administration errors in pediatric inpatients.

Implementation of a standardized protocol for administering intravenous medications was associated with a reduction in medication errors in intensive care unit patients.

The authors developed a classification scheme for errors in medication administration, and used this to prioritize interventions to prevent such errors.

The authors compared the effectiveness of risk management procedures used during intravenous therapy. They suggest development of better procedures at a national or international level.