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- Error Reporting and Analysis 2
- Human Factors Engineering 1
- Quality Improvement Strategies 1
- Technologic Approaches 1
Health Care Executives and Administrators
- Risk Managers
Health Care Providers
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- Non-Health Care Professionals 3
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- Allied Health Services
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Journal Article > Study
Pediatric airway management and prehospital patient safety: results of a national Delphi survey by the Children's Safety Initiative-Emergency Medical Services for Children.
Hansen M, Meckler G, O'Brien K, et al. Pediatr Emerg Care. 2016;32:603-607.
Appropriate airway management is a key component of resuscitation in the prehospital setting. This study surveyed prehospital professionals to understand elements of prehospital pediatric airway management that may contribute to patient safety events. Investigators found that insufficient experience with pediatric airway management and difficulty deciding when an advanced airway should be performed were viewed as highly likely to lead to safety events.
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.
Bostock L, Bairstow S, Fish S, Macleod F. London, England: Social Care Institute for Excellence; 2005. ISBN: 1904812279.
This report suggests that a systems approach to child social services in Great Britain would facilitate a fair and open culture and encourage learning from near misses.
Cases & Commentaries
- Web M&M
Jeffrey Driver, JD, MBA ; October 2004
Following a swallowing study, a speech pathologist recommends that a patient receive nothing by mouth, due to a high risk of aspiration. However, because the report is misfiled, no NPO order is implemented.