Vaccine errors can hinder immunization efforts in the United States. In this article, the authors summarize errors involving 2-component vaccines, discuss safe practices for storing, preparing, dispensing, and administering 2-component vaccines, and highlight risk reduction strategies.

According to this study, many adverse drug event reports submitted by drug manufacturers to the Food and Drug Administration were incomplete. The authors advocate for the FDA to update their reporting requirements and compliance policies.

… patient information. A prior AHRQ WebM&M interview with Michael Cohen, president of ISMP, discussed medication safety. …

Sociotechnical probabilistic risk assessment—a prospective method of identifying potential patient safety hazards—was used to assess the risk for medication errors in community pharmacies.

This commentary emphasizes the importance of developing a crisis management plan to support clinicians involved in medical error.

This commentary discusses the importance of handoff communication in ensuring safe transfers and recommends that mental models be developed within the care team to improve handoff safety.

… care leaders to prevent harm. … Federico FA, Benjamin B, Cohen M. Healthc Exec. 2011;26:80-83.   …

This report discusses examples of serious medication errors involving "sound-alike" drugs as well as use of ambiguous abbreviations.

This review highlights gaps in the current literature on handoffs, which include inadequate research supporting best practices in the context of growing mandates to do so.

This monthly column highlights an initiative to introduce safer device connectors to prevent spinal and epidural medications from being delivered intravenously, discusses the value of independent double-checks, and shares thoughts on the 35th anniversary of this column.

… in-depth look at the true impact of a never event . … Smetzer J, Baker C, Byrne FD, Cohen MR. Shaping systems for better behavioral choices: …

This monthly article discusses incidents involving dosing errors and describes strategies to promote the safe use of oral syringes.

Voluntarily reported adverse drug events increased markedly from 1998-2005, with a small proportion of drugs accounting for a disproportionate share of adverse events.

This survey, conducted by the Institute for Safe Medication Practices, captured more than 2000 health care providers' views to assess the prevalence of intimidation in patient care settings. Results suggested widespread experiences with a variety of intimidating behaviors such as condescending language, impatience with answering questions, or refusal to answer questions or a telephone call. Findings were not limited to physicians; pharmacists seemed more affected than nurses, and nearly half of respondents felt the behaviors countered necessary patient safety efforts. The authors conclude with recommendations to promote cultural change.

The authors review selected incidents of harm involving unlabeled containers and provide recommendations to prevent similar occurrences.

This article reports the results of the first national survey of mediation safety readiness in hospitals, which identified a wide range of opportunities for improvement.