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9121. MedlinePlus: Patient Safety. | PSNet
      psnet.ahrq.gov/issue/medlineplus-patient-safety
      September 29, 2017 - September 29, 2017 Identifying and Preventing Medication Errors.

9122. Facilitator Guide: Science of Safety Training & Identifying Defects (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_scienceofsafety_facnotes.docx
      December 01, 2017 - breakdowns are a significant, if not leading, cause of many undesirable outcomes, including sentinel events, medication … errors, delays in treatment, ventilator events, and healthcare-associated infections. … you would not want to happen again—an unsafe condition, a patient fall, a venous thromboembolism, a medication … error, a surgical site infection, wrong-site surgery, missing equipment, nursing time spent away from

9123. References | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/reports/hotline/refs.html
      May 01, 2016 - Consumers can prevent medication errors (Web site).

9124. Understanding and confronting our mistakes: the epidemiology of error in radiology and strategies for error reduction. | PSNet
      psnet.ahrq.gov/issue/understanding-and-confronting-our-mistakes-epidemiology-error-radiology-and-strategies-error
      February 02, 2022 - February 2, 2022 Medication error in the care of HIV/AIDS patients: electronic surveillance

9125. We need to talk: primary care provider communication at discharge in the era of a shared electronic medical record. | PSNet
      psnet.ahrq.gov/issue/we-need-talk-primary-care-provider-communication-discharge-era-shared-electronic-medical
      October 13, 2018 - March 25, 2017 WebM&M Cases Refused Medication Error

9126. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49517/psn-pdf
      August 01, 2006 - Strategies to prevent opioid errors are not substantially different from those used for other types of medication … errors, with a few exceptions. … Computerized prescriber order entry (CPOE) is a promising technology for its potential to reduce medication … errors.(11) CPOE might improve analgesic safety by preventing prescribers from ordering drugs not on

9127. Massachusetts Coalition for the Prevention of Medical Errors. | PSNet
      psnet.ahrq.gov/issue/massachusetts-coalition-prevention-medical-errors
      February 05, 2014 - Multi-use Website Massachusetts Coalition for the Prevention of Medical Errors. Citation Text: Massachusetts Coalition for the Prevention of Medical Errors. Massachusetts Coalition for the Prevention of Medical Errors Copy Citation Save Save to your library …

9128. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/41811/psn-pdf
      October 31, 2012 - resources, including posters and videos with information on hand hygiene, infection prevention, and medication … errors.

9129. Christiana Care Health System: Safety Mentor Program (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Campbell_94.pdf
      March 30, 2008 - Christiana Care Health System: Safety Mentor Program Christiana Care Health System: Safety Mentor Program Michele Campbell, RN, MSM, CPHQ; Christine Carrico, RN, MSN, CPHQ; Carol Kerrigan Moore, RN, MS, FNP-BC; Terri Lynn Palmer, MPA Abstract According to the Institute of Medicine, as many as 98,000 patients…

9130. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46575/psn-pdf
      December 13, 2017 - Economic evaluation of pharmacist-led medication reviews in residential aged care facilities. December 13, 2017 Hasan SS, Thiruchelvam K, Kow CS, et al. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities. Expert Rev Pharmacoecon Outcomes Res. 2017;17(5):431-439. doi:10.108…

9131. A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting. | PSNet
      psnet.ahrq.gov/issue/systematic-review-performance-characteristics-clinical-event-monitor-signals-used-detect
      March 28, 2012 - Related Resources From the Same Author(s) Identifying modifiable barriers to medication … error reporting in the nursing home setting.

9132. Safety culture includes "good catches." | PSNet
      psnet.ahrq.gov/issue/safety-culture-includes-good-catches
      August 21, 2024 - Improving Diagnostic Safety and Quality April 26, 2023 ISMP medication … error report analysis.

9133. Handling injectable medications in anaesthesia: Guidelines from the Association of Anaesthetists. | PSNet
      psnet.ahrq.gov/issue/handling-injectable-medications-anaesthesia-guidelines-association-anaesthetists
      March 14, 2022 - WebM&M Cases Syringe Swap During Regional Block: A Case of Medication … Error and Recovery January 31, 2024 Anesthesia workspaces for safe medication

9134. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45936/psn-pdf
      March 08, 2017 - Using information from external errors to signal a "clear and present danger." March 8, 2017 ISMP Medication Safety Alert! Acute care edition. February 9, 2017;22:1-5. https://psnet.ahrq.gov/issue/using-information-external-errors-signal-clear-and-present-danger Monitoring external reports of error and harm can pr…

9135. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47321/psn-pdf
      June 19, 2019 - Validation of a mobile app for reducing errors of administration of medications in an emergency. June 19, 2019 Baumann D, Dibbern N, Sehner S, et al. Validation of a mobile app for reducing errors of administration of medications in an emergency. J Clin Monit Comput. . 2019;33(3):531-539. doi:10.1007/s10877-018-018…

9136. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/853980/psn-pdf
      September 27, 2023 - RFID tags reduce restocking errors of anesthesia medications. September 27, 2023 Banks MA. Specialty Pharmacy Continuum. September 15, 2023. https://psnet.ahrq.gov/issue/rfid-tags-reduce-restocking-errors-anesthesia-medications Radiofrequency identification (RFID) devices are being used to improve processes in the…

9137. Final Progress Report: Cook County & Rush Developmental Center for Research in Patient Safety: Diagnosis Error Evaluation and Research (DEER) Project (pdf file)
      www.ahrq.gov/sites/default/files/2025-04/schiff-mcnutt-report.pdf
      January 01, 2025 - Although much of the patient safety spotlight has focused on medication errors, two recent studies of … malpractice claims reveal that diagnosis errors far outnumber medication errors as a cause of claims … Bates has promulgated a useful model for depicting the relationships between medication errors and outcomes … Assessing the quality of published case reports of look-alike and sound-alike medication errors. … An evaluation of the quality of the USP/ISMP Medication Error Reporting Program.

9138. About the Toolkit Development | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/about.html
      July 01, 2023 - In addition to communication failures, patients on labor and delivery (L&D) units are at risk of medication … errors due to the frequent use of high-alert medications.

9139. Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study. | PSNet
      psnet.ahrq.gov/issue/prevalence-and-characterisation-diagnostic-error-among-7-day-all-cause-hospital-medicine
      April 12, 2023 - Study Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study. Citation Text: Raffel KE, Kantor MA, Barish P, et al. Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine …

9140. Mistaken Identity | PSNet
      psnet.ahrq.gov/web-mm/mistaken-identity
      December 18, 2014 - Medication errors in the neonatal intensive care unit: special patients, unique issues.