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Journal Article > Review
Masotti P, McColl MA, Green M. Int J Qual Health Care. 2010;22:115-125.
Early efforts in patient safety have focused on error reduction in hospitalized patients, and the ambulatory setting is rapidly emerging with its own body of research. However, patients enrolled in hospice, nursing homes, and homecare settings are underrepresented in the safety literature. This study analyzed more than 160 studies to develop a taxonomy for adverse events in the homecare setting. Categories included adverse drug events and line-related problems as well as the expected focus on wounds and falls. Investigators reported that adverse event rates ranged from 3%–15%, with few intervention trials addressing these opportunities for improvement. The authors advocate for standardized definitions of common homecare–setting events that can foster necessary efforts to improve care for patients in this environment. A related editorial [see link below] discusses the opportunities to advance our understanding of patient safety in the homecare setting.
Journal Article > Study
Analysis of adverse events in pediatric surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome measures.
Rice-Townsend S, Hall M, Jenkins KJ, Roberson DW, Rangel SJ. J Pediatr Surg. 2010;45:1126-1136.
This study sought to characterize the incidence and types of adverse events in pediatric surgery patients, using measures (the National Surgical Quality Improvement Program and the AHRQ Patient Safety Indicators) originally developed for identifying adverse events in adults. The authors argue that applying adult measures to a pediatric population overestimates the incidence of adverse events.
Special or Theme Issue
J Am Coll Surg. 2011;212:921-990.
Articles in this special issue explore the effectiveness of AHRQ Patient Safety Indicators in VA hospitals.
Journal Article > Study
On the CUSP: Stop BSI: evaluating the relationship between central line–associated bloodstream infection rate and patient safety climate profile.
Weaver SJ, Weeks K, Pham JC, Pronovost PJ. Am J Infect Control. 2014;42(suppl 10):S203-S208.
This study determined that results from the AHRQ Hospital Survey on Patient Safety were associated with differences in central line–associated bloodstream infection rates. The authors found five different overall patterns of responses which they propose as distinct safety climates. These results argue for integrating survey results rather than testing whether each separate aspect of safety climate is linked to a particular safety problem.