AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (202)

•Diagnostic Errors (157)

•Identification Errors (128)

•Discontinuities, Gaps, and Hand-Off Problems (464)

•Fatigue and Sleep Deprivation (103)

•Medication Safety (1227)

•Medical Complications (493)

•Nonsurgical Procedural Complications (92)

•Surgical Complications (375)

•Transfusion Complications (21)

•Psychological and Social Complications (148)

Origin/Sponsor

•Australia and New Zealand (126)

•Central and South America (7)

•Europe (496)

•North America (3495)

Resource Types

•Audiovisual (31)

•Bibliography (3)

•Book/Report (303)

•Clinical Guideline (4)

•Journal Article (3089)

•Legislation/Regulation (57)

•Meeting/Conference (45)

•Newsletter/Journal (12)

•Newspaper/Magazine Article (395)

•Press Release/Announcement (39)

•Special or Theme Issue (72)

•Tools/Toolkit (65)

•Web Resource (115)

Error Types

•Epidemiology of Errors and Adverse Events (922)

•Active Errors (640)

•Latent Errors (278)

•Near Miss (80)

Approach to Improving Safety

•Quality Improvement Strategies (1148)

•Legal and Policy Approaches (498)

•Error Reporting and Analysis (1242)

•Communication Improvement (962)

•Human Factors Engineering (549)

•Teamwork (352)

•Specialization of Care (311)

•Logistical Approaches (331)

•Culture of Safety (743)

•Technologic Approaches (783)

•Education and Training (844)

Clinical Areas

•Allied Health Services (18)

•Dentistry (2)

•Medicine (2662)

•Nursing (493)

•Pharmacy (431)

Target Audience
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Health Care Executives and Administrators

•Facility and Group Administrators (312)

•Nurse Managers (455)

•Risk Managers (427)

•Quality and Safety Professionals (1624)

Setting of Care

•Hospitals (2793)

•Psychiatric Facilities (18)

•Residential Facilities (81)

•Ambulatory Care (322)

•Outpatient Surgery (35)

•Patient Transport (28)

1 - 20 of 4280

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STUDY

Intravenous infusion safety technology: return on investment.

Danello SH, Maddox RR, Schaack GJ. Hosp Pharm. 2009;44:680-687, 696.

COMMENTARY

Preparing your hospital for compliance with The Joint Commission's National Patient Safety Goals.

Murdaugh L, Jordin R. Hosp Pharm. 2008;43:728-733.

NEWSPAPER/MAGAZINE ARTICLE

Misprogramming PCA concentration leads to dosing errors.

ISMP Medication Safety Alert! Acute Care Edition. August 28, 2008;13:1-3.

COMMENTARY

Improving heparin safety: a multidisciplinary invited conference.

Peterson C, Ham CW, Vanderveen T. Hosp Pharm. 2008;43:491-497.

COMMENTARY

ISMP medication error report analysis.

Smetzer JL, Cohen MR. Hosp Pharm. 2008;43;788-792.

STUDY

A case study on the safety impact of implementing smart patient-controlled analgesic pumps at a tertiary care academic medical center.

Tran M, Ciarkowski S, Wagner D, Stevenson JG. Jt Comm J Qual Patient Saf. 2012;38:112-119.

NEWSPAPER/MAGAZINE ARTICLE

Medication errors occurring with the use of bar-code administration technology.

PA-PSRS Patient Saf Advis. December 2008;5:122-126.

NEWSPAPER/MAGAZINE ARTICLE

Anticoagulant safety practices call for pharmacist supervision.

Scott A. Drug Topics (Health-System Edition). November 10, 2008.

ORGANIZATIONAL POLICY/GUIDELINES

Preventing errors relating to commonly used anticoagulants.

Sentinel Event Alert. September 24, 2008;(41):1-4.

STUDY

Medication safety initiative in reducing medication errors.

Nguyen EE, Connolly PM, Wong V. J Nurs Care Qual. 2010;25:224-230.

REVIEW

Bar code technology and medication administration error.

Young J, Slebodnik M, Sands L. J Patient Saf. 2010;6;115-120.

COMMENTARY

ISMP medication error report analysis.

Cohen MR. Hosp Pharm. 2008;43:696–698.

COMMENTARY

ISMP medication error report analysis.

Cohen MR. Hosp Pharm. 2009;44:654-657.

STUDY

classic

Effect of bar-code technology on the safety of medication administration.

Poon EG, Keohane CA, Yoon CS, et al. N Engl J Med. 2010;362:1698-1707.

NEWSPAPER/MAGAZINE ARTICLE

How has the current economy affected patient safety?

ISMP Medication Safety Alert! Acute Care Edition. September 10, 2009;14:1-2.

COMMENTARY

ISMP medication error report analysis.

Cohen MR, Smetzer JL. Hosp Pharm. 2010;45:191-195.

BOOK/REPORT

Patient Safety Authority Annual Reports.

Harrisburg, PA: Patient Safety Authority; April 2013.

BOOK/REPORT

Inpatient Computerized Provider Order Entry: Findings from the AHRQ Health IT Portfolio.

Dixon BE, Zafar A, for AHRQ National Resource Center for Health IT. Rockville, MD: Agency for Healthcare Research and Quality; January 2009. AHRQ Publication No. 09-0031-EF.

COMMENTARY

Learning accountability for patient outcomes.

Pronovost PJ. JAMA. 2010;304:204-205.

MULTI-USE WEBSITE

BOOSTing Care Transitions Resource Room.

Project BOOST (Better Outcomes for Older adults through Safe Transitions), Society of Hospital Medicine.

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