U.S. Department of Health & Human Services
General Internal Medicine
PATIENT SAFETY PRIMERS
2014 ANNUAL PERSPECTIVES
Device-related Complications (59)
Diagnostic Errors (57)
Identification Errors (29)
Discontinuities, Gaps, and Hand-Off Problems (267)
Fatigue and Sleep Deprivation (47)
Medication Safety (407)
Medical Complications (267)
Nonsurgical Procedural Complications (15)
Surgical Complications (73)
Transfusion Complications (10)
Psychological and Social Complications (72)
Australia and New Zealand (56)
Central and South America (2)
North America (1359)
Clinical Guideline (1)
Journal Article (1295)
Newspaper/Magazine Article (198)
Press Release/Announcement (4)
Special or Theme Issue (14)
Web Resource (39)
Epidemiology of Errors and Adverse Events (504)
Active Errors (247)
Latent Errors (198)
Near Miss (23)
Approach to Improving Safety
Quality Improvement Strategies (406)
Legal and Policy Approaches (183)
Error Reporting and Analysis (528)
Communication Improvement (438)
Human Factors Engineering (161)
Specialization of Care (117)
Logistical Approaches (134)
Culture of Safety (278)
Technologic Approaches (282)
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General Internal Medicine
Health Care Providers (986)
Health Care Executives and Administrators (1431)
Non-Health Care Professionals (766)
Setting of Care
Psychiatric Facilities (5)
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Ambulatory Care (208)
Outpatient Surgery (4)
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New 2012 National Patient Safety Goal - catheter-associated urinary tract infection (CAUTI).
Oakbrook Terrace, IL: Joint Commission; May 17, 2011.
On the CUSP: Stop HAI.
Health Research & Educational Trust, MHA Keystone Center.
Preventing Central Line–Associated Bloodstream Infections: a Global Challenge, a Global Perspective.
The Joint Commission. Oakbrook Terrace, IL: Joint Commission Resources; May 2012.
Tubing Misconnections Self Assessment for Healthcare Facilities.
Horsham, PA: Institute for Safe Medication Practices, Deerfield, IL: Baxter Healthcare; 2012.
Eliminating Catheter-Associated Urinary Tract Infections.
Chicago, IL: Health Research & Educational Trust; July 2013.
Administering a saline flush "site unseen" can lead to a wrong route error.
ISMP Medication Safety Alert! Acute Care Edition. May 16, 2013;18:1-3.
Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior.
Clare CA, Afzal O, Knapp K, Viola D. J Patient Saf. 2013;9:68-74.
Supratherapeutic dosing of acetaminophen among hospitalized patients.
Zhou L, Maviglia SM, Mahoney LM, et al. Arch Intern Med. 2012;172:1721-1728.
Infusing fun into quality and safety initiatives.
Foulk KC, Tocydlowski P, Snow TM, et al. Nursing. 2012;42:14-16.
A multidisciplinary approach to reduce central line–associated bloodstream infections.
McMullan C, Propper G, Schuhmacher C, et al. Jt Comm J Qual Patient Saf. 2013;39:61-69.
Parent willingness to remind health care workers to perform hand hygiene.
Buser GL, Fisher BT, Shea JA, Coffin SE. Am J Infect Control. 2013;41:492-496.
Five Years of Quality: Working Together to Improve Care.
Tallahassee, FL: Florida Hospital Association; August 2013.
Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.
Fakih MG, George C, Edson BS, Goeschel CA, Saint S. Infect Control Hosp Epidemiol. 2013;34:1048-1054.
Application of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines.
Fuller C, Besser S, Savage J, McAteer J, Stone S, Michie S. Am J Infect Control. 2014;42:106-110.
Factors contributing to all-cause 30-day readmissions: a structured case series across 18 hospitals.
Feigenbaum P, Neuwirth E, Trowbridge L, et al. Med Care. 2012;50:599-605.
Events associated with the prescribing, dispensing, and administering of medication loading doses.
Carson SL, Gaunt MJ. PA-PSRS Patient Saf Advis. 2012;9:82-88.
Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series.
Kirkland KB, Homa KA, Lasky RA, Ptak JA, Taylor EA, Splaine ME. BMJ Qual Saf. 2012;21:1019-1026.
Health Care–Associated Infections (HAI) Portal.
The Joint Commission.
Utilizing improvement science methods to improve physician compliance with proper hand hygiene.
White CM, Statile AM, Conway PH, et al. Pediatrics. 2012;129:e1042-e1050.
Saving lives by studying deaths: using standardized mortality reviews to improve inpatient safety.
Lau H, Litman KC. Jt Comm J Qual Patient Saf. 2011;37:400-408.
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