Narrow Results Clear All
- Communication Improvement 1
- Culture of Safety 1
- Education and Training 7
- Error Reporting and Analysis 9
- Human Factors Engineering
- Legal and Policy Approaches 6
- Logistical Approaches 1
- Policies and Operations 1
- Quality Improvement Strategies 8
- Specialization of Care 2
- Technologic Approaches 11
- Transparency and Accountability 1
- Device-related Complications 20
- Discontinuities, Gaps, and Hand-Off Problems 1
- Identification Errors 1
- Medical Complications 1
- Medication Safety 15
- MRI safety 1
- Nonsurgical Procedural Complications 4
- Surgical Complications 1
- Allied Health Services 1
- Internal Medicine 11
- Pediatrics 3
- Nursing 4
- Pharmacy 6
- Family Members and Caregivers 2
- Health Care Executives and Administrators 19
Health Care Providers
- Nurses 7
Non-Health Care Professionals
- Engineers 14
- Patients 11
Search results for "Newspaper/Magazine Article"
- Newspaper/Magazine Article
- Medical Device Design
Jewett C. Kaiser Health News. May 3, 2019.
Transparency has been heralded as a cornerstone to improvement in health care. This news article reports on a government alternative summary reporting program that allowed medical device makers to conceal safety events and malfunction reports associated with medical devices. A new program that expands access to information about device-related failures will be put in place.
Mohr H, Weiss M. Associated Press. November 27, 2018.
Mix-ups between epidural analgesia and IV antibiotics in labor and delivery units continue to cause harm.
ISMP Medication Safety Alert! Acute Care Edition. October 4, 2018;23:1-4.
Increased urgency to prevent maternal mortality has uncovered various factors that diminish safety. This newsletter article reports on incidents involving the accidental misuse of epidural analgesia and intravenous antibiotics in labor and delivery care, describes contributing factors (e.g., health technology missteps, barcoding mistakes, and look-alike medications), and offers improvement strategies to mitigate harm.
ISMP Medication Safety Alert! Acute Care Edition. May 31, 2018;23:1-4.
Smart pumps offer both benefits and drawbacks that can affect medication safety. This newsletter article explores missteps related to lack of compliance with setting hard stops to protect patients when using unique intravenous medication concentrations. Recommendations to prevent errors include using standardized dosing concentrations as often as possible, adhering to metric unit dosing requirements, and verifying pump programming settings.
Sun LH. The Washington Post. October 13, 2016.
Medical devices can contribute to the spread of health care–associated infections. This news article discusses a government report that raises concerns that patients may have been exposed to a deadly bacterial infection related to an essential piece of equipment used in cardiac surgery worldwide. The resulting infection can be difficult to diagnosis as symptoms may remain dormant for months after the initial exposure.
Multifaceted initiative to reduce "alarm fatigue" on cardiac unit reduces alarms and increases nurse and patient satisfaction.
Agency for Healthcare Research and Quality. Health Care Innovations Exchange. June 18, 2014.
Clinical alarms have been described as a serious patient safety issue. This article relates how one hospital implemented a series of actions reduce nuisance alarms in a cardiac unit and reports a substantial decrease in audible alerts with no subsequent adverse effects. Interventions included expanding limits for triggering heart rate alarms and collaboration between two nurses to design customized alarm parameters for individual patients.
Jaffe E. Fast Company. November 11, 2013.
This article reports on a British initiative that studied health care processes for the purpose of designing devices to prevent medical errors.
Dyell D. Patient Saf Qual Healthc. January/February 2012;9:34-37.
This magazine article describes problems with medical devices and recommends that device connectivity and integration can improve safety.
ISMP Canada Safety Bulletin. July 31, 2011;11:1-2.
This announcement reports on mistaken intravenous administration of breast milk and provides recommendations to prevent parenteral administration of enteral nutrition.
Harasim P. Las Vegas Review-Journal. November 21, 2010;News:1B.
This article discusses how the organizational system of one hospital delayed an investigation into catheter line malfunctions.
ISMP Medication Safety Alert! Acute Care Edition. July 15, 2010;15:1-2.
This piece describes reports of tubing misconnections and discusses upcoming standards for connectors that will prevent such errors.
ISMP Medication Safety Alert! Acute Care Edition. April 8, 2010;15:1-3.
Health IT Law & Industry Report; February 26, 2010.
This news article covers federal testimony in support of health information technology (HIT) system regulation by the United States Food and Drug Administration (FDA). The piece describes safety concerns that could result from HIT and discusses potential regulatory approaches to improvement, such as third-party reporting, confidentiality, and limited liability.
Kowalczyk L. Boston Globe. February 21, 2010.
This news account discusses a patient death after a heart monitor alarm was inadvertently turned off. Hospital and device safety experts weigh in on strategies to prevent these types of errors.
Bogdanich W. New York Times. January 24, 2010:A1.
First in a series on medical radiation, this news feature and accompanying video investigate patient deaths and injuries following mistakes related to radiation treatment. The journalists discuss the number of radiation therapy errors in New York and reveal that state law does not require public reporting of such mistakes.
Daner WE, Gosselin RC, Raschke R, Vanderveen T. Patient Saf Qual Healthcare. January/February 2009;6:20-25.
This article explains safety challenges commonly associated with heparin, a high-alert medication, and outlines how hospitals and clinicians can prevent these errors.
ISMP Medication Safety Alert! Acute Care Edition. August 14, 2008;13:1-3.
This article reports on an overdose caused by improper label placement on a patient controlled analgesia (PCA) pump and provides recommendations for preventing pump-related medication errors.
This article reports on two projects developed at the Center for Integration of Medicine and Innovative Technology that demonstrate functional device interoperability in hospital operating rooms.
ISMP Medication Safety Alert! Acute Care Edition. July 3, 2008;13:1-3.
This article reports on the potentially fatal error of administering epidural medications intravenously and provides guidelines to safeguard against such epidural–IV route mix-ups.
ISMP Medication Safety Alert! Acute Care Edition. May 8, 2008;13:1-3.
This article describes common problems associated with insulin pen injectors and provides recommendations for their safe use.