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The medication-use process is highly complex with many steps and risk points for error, and those errors are a key target for improving safety. This Library reflects a curated selection of PSNet content focused on medication and drug errors. Included resources explore understanding harms from preventable medication use, medication safety improvement strategies, and resources for design.

King L, Peacock G, Crotty M, et al. Health Expect. 2019;22:385-395.
Patients and families have the potential to help medical teams proactively detect clinical deteriorations. This qualitative study with consumer advocates resulted in a comprehensive model for empowering patients to accurately activate rapid response systems.
Guinane J, Hutchinson AM, Bucknall TK. J Clin Nurs. 2018;27:1621-1631.
Rapid response teams are well established in adult and pediatric hospitals. As part of efforts to increase patient engagement in safety efforts, some hospitals allow patients to summon the team directly. This qualitative study of patients and caregivers at two Australian hospitals identified significant barriers to family-activated rapid response teams. Principally, patients did not feel they had the knowledge to make a clinical decision regarding their care and expressed concern about overriding the clinical staff's decisions.
Gill FJ, Leslie GD, Marshall AP. Worldviews Evid Based Nurs. 2016;13:303-13.
Rapid response teams (RRTs) are a widely implemented safety intervention with a growing body of literature supporting their effectiveness. At some hospitals, families can activate the RRT if they are concerned. This systematic review identified successful implementation strategies for family-activated RRTs, but researchers found no clear evidence that this approach improves patient outcomes.
Collier A, Sorensen R, Iedema R. Int J Qual Health Care. 2016;28:66-73.
This ethnographic study revealed dying patients' and their families' perceptions of iatrogenic harm. Communication-related harms were considered distressing to the patients and their families. These results underscore the importance of maintaining trust in end-of-life care to augment safety.
Manias E. Health Expect. 2015;18:850-66.
Polypharmacy, or taking multiple medications, is a risk factor for adverse drug events. This interview study examined how family members participated in medication management for hospitalized patients taking five or more medications and found that communication between family members and health care professionals was insufficient. The authors advocate for providers to proactively engage in discussions with family members as they can know important information regarding patients' medications.
Iedema R, Jorm C, Wakefield JG, et al. J Lang Soc Psychol. 2009;28.
Open disclosure is an important principle and policy in health care, with varying views on its implementation among providers and varying practices in different countries. This article discusses the broad context of an open disclosure policy and provides an empirical analysis of the impact on clinicians.
Iedema R, Allen S, Britton K, et al. BMJ. 2011;343:d4423.
Clinicians’ approach to disclosing errors has evolved in recent years, thanks to survey data showing that patients consistently desire full disclosure of errors. In Australia, an open disclosure policy was formally endorsed in 2008. This study used in-depth interviews with 100 patients who experienced errors, and went through the error disclosure process to evaluate the perception of patients (and their families) of the disclosure process. Patients consistently stated that how errors were disclosed affected their feelings about the process, even if all relevant information was disclosed. Many patients complained that they were not adequately prepared for disclosure meetings, did not feel they had the opportunity to ask questions, or had difficulty obtaining follow-up after the initial meeting. As full disclosure policies become more widely implemented, this study provides important guidance for implementing disclosure policies that are truly patient-centered.