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Journal Article > Commentary
Henriksen K, Brady J. BMJ Qual Saf. 2013;22(supp 2):1-5.
Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit.
ISMP Medication Safety Alert! Acute Care Edition. March 21, 2013;18:1-3.
This newsletter article discusses factors that contributed to the death of a patient in an ambulatory surgery center and recommends improved monitoring practices and alarm management in post-anesthesia care units.
Journal Article > Study
Prevention of a wrong-location misadministration through the use of an intradepartmental incident learning system.
Ford EC, Smith K, Harris K, Terezakis S. Med Phys. 2012;39:6968-6971.