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Volumn 31, Issue 4, 2010, Pages 151-158

Patient safety and quality improvement: Medical errors and adverse events

Author keywords

[No Author keywords available]

Indexed keywords

ACETAZOLAMIDE; AMOXICILLIN; ANTIHISTAMINIC AGENT; AZITHROMYCIN; CEFTRIAXONE; CETIRIZINE; FLUMAZENIL; NALOXONE; OLANZAPINE; OSELTAMIVIR; RANITIDINE; SALICYLIC ACID; VANCOMYCIN;

EID: 77950837340     PISSN: 01919601     EISSN: 15263347     Source Type: Journal    
DOI: 10.1542/pir.31-4-151     Document Type: Review
Times cited : (13)

References (55)
  • 1
    • 0003413171 scopus 로고    scopus 로고
    • Kohn LT, Corrigan JM, Donaldson MS, eds Washington, DC: National Academy Press
    • Kohn LT, Corrigan JM, Donaldson MS, eds To Err Is Human: Building A Safer Health System Washington, DC: National Academy Press 1999
    • (1999) To Err Is Human: Building A Safer Health System
  • 2
    • 0003469595 scopus 로고    scopus 로고
    • Rockville Md: Agency for Healthcare Research and Quality
    • Medical Errors: The Scope of the Problem. Rockville, Md: Agency for Healthcare Research and Quality; 2000
    • (2000) Medical Errors: The Scope of the Problem
  • 3
    • 0034595191 scopus 로고    scopus 로고
    • Error in medicine: What have we learned?
    • Bates DW, Gawande AA. Error in medicine: what have we learned? Ann Intern Med. 2000;132:763-767 (Pubitemid 30244184)
    • (2000) Annals of Internal Medicine , vol.132 , Issue.9 , pp. 763-767
    • Bates, D.W.1    Gawande, A.A.2
  • 4
    • 44449092999 scopus 로고    scopus 로고
    • Preventing pediatric medication errors
    • Oakbrook Terrace, Ill: The Joint Commission
    • Preventing pediatric medication errors. Sentinel Event Alert. Oakbrook Terrace, Ill: The Joint Commission; 2008
    • (2008) Sentinel Event Alert
  • 6
    • 34548181277 scopus 로고    scopus 로고
    • Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care
    • DOI 10.1345/aph.1H658
    • Thomsen LA, Winterstein AG, Sondergaard B, Haugbolle LS, Melander A. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Ann Phar-macother. 2007;41:1411-1426 (Pubitemid 47311361)
    • (2007) Annals of Pharmacotherapy , vol.41 , Issue.9 , pp. 1411-1426
    • Thomsen, L.A.1    Winterstein, A.G.2    Sondergaard, B.3    Haugbolle, L.S.4    Melander, A.5
  • 7
    • 0029066463 scopus 로고
    • Incidence of adverse drug events and potential adverse drug events. Implications for prevention
    • ADE Prevention Study Group
    • Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995;274:29-34
    • (1995) JAMA , vol.274 , pp. 29-34
    • Bates, D.W.1    Cullen, D.J.2    Laird, N.3
  • 8
    • 0014457089 scopus 로고
    • International drug monitoring. the role of the hospital
    • International drug monitoring. The role of the hospital. WHO Tech Rep Ser. 1969;425:5-24
    • (1969) WHO Tech Rep ser , vol.425 , pp. 5-24
  • 9
    • 77950819348 scopus 로고    scopus 로고
    • Sentinel events
    • Accessed January 2010
    • Sentinel Events. Oakbrook Terrace, Ill: The Joint Commission; 2007. Accessed January 2010 at: http://www.jointcommission.org/SentinelEvents/
    • (2007) Oakbrook Terrace, Ill: The Joint Commission
  • 11
    • 0025924692 scopus 로고
    • Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study i
    • Brennan TA, Leape LL, Laird NM, Hebert L, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Medicine. 1991; 324:370-376
    • (1991) N Engl J Medicine , vol.324 , pp. 370-376
    • Brennan, T.A.1    Leape, L.L.2    Laird, N.M.3    Hebert, L.4
  • 12
    • 0026022279 scopus 로고
    • The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II
    • Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324:377-384
    • (1991) N Engl J Med , vol.324 , pp. 377-384
    • Leape, L.L.1    Brennan, T.A.2    Laird, N.3
  • 13
    • 0032701645 scopus 로고    scopus 로고
    • Costs of medical injuries in Utah and Colorado
    • Thomas E, Studdert D, Newhouse J, et al. Costs of medical injuries in Utah and Colorado. Inquiry. 1999;36:255-264
    • (1999) Inquiry , vol.36 , pp. 255-264
    • Thomas, E.1    Studdert, D.2    Newhouse, J.3
  • 15
    • 0027767320 scopus 로고
    • Using a hospital information system to assess the effects of adverse drug events
    • Evans R, Classen D, Stevens L, et al. Using a hospital information system to assess the effects of adverse drug events. Proc Annu Symp Comput Appl Med Care. 1993:161-165
    • (1993) Proc Annu Symp Comput Appl Med Care , pp. 161-165
    • Evans, R.1    Classen, D.2    Stevens, L.3
  • 16
    • 0031032055 scopus 로고    scopus 로고
    • Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality
    • Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277:301-306
    • (1997) JAMA , vol.277 , pp. 301-306
    • Classen, D.C.1    Pestotnik, S.L.2    Evans, R.S.3    Lloyd, J.F.4    Burke, J.P.5
  • 17
    • 16844373959 scopus 로고    scopus 로고
    • Adverse events and preventable adverse events in children
    • DOI 10.1542/peds.2004-0410
    • Woods D, Thomas E, Holl J, Altman S, Brennan T. Adverse events and preventable adverse events in children. Pediatrics. 2005; 115:155-160 (Pubitemid 43046294)
    • (2005) Pediatrics , vol.115 , Issue.1 , pp. 155-160
    • Woods, D.1    Thomas, E.2    Holl, J.3    Altman, S.4    Brennan, T.5
  • 19
    • 0034231512 scopus 로고    scopus 로고
    • Prevalence of errors in a pediatric hospital medication system: Implications for error proofing
    • Marino BL, Reinhardt K, Eichelberger WJ, Steingard R. Prevalence of errors in a pediatric hospital medication system: implications for error proofing. Outcomes Manag Nurs Pract. 2000;4: 129-135
    • (2000) Outcomes Manag Nurs Pract , vol.4 , pp. 129-135
    • Marino, B.L.1    Reinhardt, K.2    Eichelberger, W.J.3    Steingard, R.4
  • 20
    • 42949162620 scopus 로고    scopus 로고
    • Development, testing, and findings of a pediatric-focused trigger tool to identify medication-related harm in US children's hospitals
    • Takata GS, Mason W, Taketomo C, Logsdon T, Sharek PJ. Development, testing, and findings of a pediatric-focused trigger tool to identify medication-related harm in US children's hospitals. Pediatrics. 2008;121:e927-e935
    • (2008) Pediatrics , vol.121
    • Takata, G.S.1    Mason, W.2    Taketomo, C.3    Logsdon, T.4    Sharek, P.J.5
  • 22
    • 34249899670 scopus 로고    scopus 로고
    • Incidence and nature of medication errors in neonatal intensive care with strategies to improve safety: A review of the current literature
    • DOI 10.2165/00002018-200730060-00004
    • Chedoe I, Molendijk HA, Dittrich ST, et al. Incidence and nature of medication errors in neonatal intensive care with strategies to improve safety: a review of the current literature. Drug Safety. 2007;30:503-513 (Pubitemid 46873075)
    • (2007) Drug Safety , vol.30 , Issue.6 , pp. 503-513
    • Chedoe, I.1    Molendijk, H.A.2    Dittrich, S.T.A.M.3    Jansman, F.G.A.4    Harting, J.W.5    Brouwers, J.R.B.J.6    Taxis, K.7
  • 23
    • 0842302604 scopus 로고    scopus 로고
    • Pediatric patient safety in the ambulatory setting
    • DOI 10.1367/1539-4409(2004)004<0047:PPSITA>2.0.CO;2
    • Miller MR, Pronovost PJ, Burstin HR. Pediatric patient safety in the ambulatory setting. Ambul Pediatr. 2004;4:47-54 (Pubitemid 38180873)
    • (2004) Ambulatory Pediatrics , vol.4 , Issue.1 , pp. 47-54
    • Miller, M.R.1    Pronovost, P.J.2    Burstin, H.R.3
  • 25
    • 77950855381 scopus 로고    scopus 로고
    • Track star's death blamed on pain cream
    • New York NY
    • Klatell JM. Track star's death blamed on pain cream. CBS News. New York, NY; 2007
    • (2007) CBS News
    • Klatell, J.M.1
  • 27
    • 77950833381 scopus 로고    scopus 로고
    • Application of a systems approach to medication safety
    • Caty MG, ed New York, NY: Informa Healthcare
    • Leonard MS. Application of a systems approach to medication safety. In: Caty MG, ed. Complications in Pediatric Surgery. New York, NY: Informa Healthcare; 2008:91-98
    • (2008) Complications in Pediatric Surgery , pp. 91-98
    • Leonard, M.S.1
  • 28
    • 0037699987 scopus 로고    scopus 로고
    • Adverse drug event trigger tool: A practical methodology for measuring medication related harm
    • Rozich JD, Haraden CR, Resar RK. Adverse drug event trigger tool: a practical methodology for measuring medication related harm. Qual Saf Health Care. 2003;12:194-200
    • (2003) Qual Saf Health Care , vol.12 , pp. 194-200
    • Rozich, J.D.1    Haraden, C.R.2    Resar, R.K.3
  • 29
    • 33745316408 scopus 로고    scopus 로고
    • Pediatric medication safety and the media: What does the public see?
    • DOI 10.1542/peds.2005-2017
    • Stebbing C, Kaushal R, Bates DW. Pediatric medication safety and the media: what does the public see? Pediatrics. 2006;117: 1907-1914 (Pubitemid 46071233)
    • (2006) Pediatrics , vol.117 , Issue.6 , pp. 1907-1914
    • Stebbing, C.1    Kaushal, R.2    Bates, D.W.3
  • 31
    • 77950818234 scopus 로고    scopus 로고
    • A legal perspective on errors in medicine
    • Caty MG, ed New York, NY: In-forma Healthcare
    • Laing LC. A legal perspective on errors in medicine. In: Caty MG, ed. Complications in Pediatric Surgery. New York, NY: In-forma Healthcare; 2008:25-69
    • (2008) Complications in Pediatric Surgery , pp. 25-69
    • Laing, L.C.1
  • 32
    • 2342500953 scopus 로고    scopus 로고
    • Achieving closure through disclosure: Experience in a pediatric institution
    • DOI 10.1016/j.jpeds.2004.01.013
    • Matlow A, Stevens P, Harrison C, Laxer R. Achieving closure through disclosure: experience in a pediatric institution. J Pediatr. 2004;144:559-560 (Pubitemid 38594750)
    • (2004) Journal of Pediatrics , vol.144 , Issue.5 , pp. 559-560
    • Matlow, A.1    Stevens, P.2    Harrison, C.3    Laxer, R.4
  • 33
    • 0034681752 scopus 로고    scopus 로고
    • Medical error: The second victim. the doctor who makes the mistake needs help too
    • Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000;320:726-727
    • (2000) BMJ , vol.320 , pp. 726-727
    • Wu, A.W.1
  • 36
    • 33750126762 scopus 로고    scopus 로고
    • Risk reduction for adverse drug events through sequential implementation of patient safety initiatives in a children's hospital
    • DOI 10.1542/peds.2005-3183
    • Leonard MS, Cimino M, Shaha S, McDougal S, Pilliod J, Brodsky L. Risk reduction for adverse drug events through sequential implementation of patient safety initiatives in a children's hospital. Pediatrics. 2006;118:e1124-e1129 (Pubitemid 46393761)
    • (2006) Pediatrics , vol.118 , Issue.4
    • Leonard, M.S.1    Cimino, M.2    Shaha, S.3    McDougal, S.4    Pilliod, J.5    Brodsky, L.6
  • 37
    • 0023256955 scopus 로고
    • Medication error prevention by clinical pharmacists in two children's hospitals
    • Folli HL, Poole RL, Benitz WE, Russo JC. Medication error prevention by clinical pharmacists in two children's hospitals. Pediatrics. 1987;79:718-722
    • (1987) Pediatrics , vol.79 , pp. 718-722
    • Folli, H.L.1    Poole, R.L.2    Benitz, W.E.3    Russo, J.C.4
  • 39
    • 0022446057 scopus 로고
    • Tenfold errors in administration of drug doses: A neglected iatrogenic disease in pediatrics
    • Koren G, Barzilay Z, Greenwald M. Tenfold errors in administration of drug doses: a neglected iatrogenic disease in pediatrics. Pediatrics. 1986;77:848-849 (Pubitemid 16066300)
    • (1986) Pediatrics , vol.77 , Issue.6 , pp. 848-849
    • Koren, G.1    Barzilay, Z.2    Greenwald, M.3
  • 40
    • 0031899238 scopus 로고    scopus 로고
    • Errors in the use of medication dosage equations
    • Lesar TS. Errors in the use of medication dosage equations. Arch Pediatr Adolesc Med. 1998;152:340-341
    • (1998) Arch Pediatr Adolesc Med , vol.152 , pp. 340-341
    • Lesar, T.S.1
  • 42
    • 0032799909 scopus 로고    scopus 로고
    • Olanzapine pediatric overdose
    • Bond GR, Thompson JD. Olanzapine pediatric overdose.Ann Emerg Med. 1999;34:292-293
    • (1999) Ann Emerg Med , vol.34 , pp. 292-293
    • Bond, G.R.1    Thompson, J.D.2
  • 44
    • 0038482036 scopus 로고    scopus 로고
    • Computer physician order entry: Benefits, costs, and issues
    • Kuperman GJ, Gibson RF. Computer physician order entry: benefits, costs, and issues. Ann Intern Med. 2003;139:31-39
    • (2003) Ann Intern Med , vol.139 , pp. 31-39
    • Kuperman, G.J.1    Gibson, R.F.2
  • 45
    • 0037663736 scopus 로고    scopus 로고
    • Effects of computerized physician order entry and clinical decision support systems on medication safety: A systematic review
    • DOI 10.1001/archinte.163.12.1409
    • Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med. 2003;163:1409-1416 (Pubitemid 36758913)
    • (2003) Archives of Internal Medicine , vol.163 , Issue.12 , pp. 1409-1416
    • Kaushal, R.1    Shojania, K.G.2    Bates, D.W.3
  • 48
    • 77950791024 scopus 로고    scopus 로고
    • Establishing a culture of patient safety through a low-tech approach to reducing medication errors
    • Advances in Patient Safety
    • Shaha S, Brodsky L, Leonard MS, et al. Establishing a culture of patient safety through a low-tech approach to reducing medication errors. In: Advances in Patient Safety. Rockville, Md: Agency for Healthcare Research and Quality; 2005
    • (2005) Rockville Md: Agency for Healthcare Research and Quality
    • Shaha, S.1    Brodsky, L.2    Leonard, M.S.3
  • 49
    • 33646434799 scopus 로고    scopus 로고
    • Clinical pharmacists and inpatient medical care: A systematic review
    • Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166:955-964
    • (2006) Arch Intern Med , vol.166 , pp. 955-964
    • Kaboli, P.J.1    Hoth, A.B.2    McClimon, B.J.3    Schnipper, J.L.4
  • 50
    • 0033591952 scopus 로고    scopus 로고
    • Pharmacist participa-tion on physician rounds and adverse drug events in the intensive care unit
    • Leape LL, Cullen DJ, Clapp MD, et al. Pharmacist participa-tion on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282:267-270
    • (1999) JAMA , vol.282 , pp. 267-270
    • Leape, L.L.1    Cullen, D.J.2    Clapp, M.D.3
  • 52
    • 0036219335 scopus 로고    scopus 로고
    • Impact of a pediatric clinical pharmacist in the pediatric intensive care unit
    • Krupicka MI, Bratton SL, Sonnenthal K, Goldstein B. Impact of a pediatric clinical pharmacist in the pediatric intensive care unit. Crit Care Med. 2002;30:919-921 (Pubitemid 34297819)
    • (2002) Critical Care Medicine , vol.30 , Issue.4 , pp. 919-921
    • Krupicka, M.I.1    Bratton, S.L.2    Sonnenthal, K.3    Goldstein, B.4
  • 53
    • 21544452805 scopus 로고    scopus 로고
    • How to avoid paediatric medication errors: A user's guide to the literature
    • DOI 10.1136/adc.2003.048827
    • Walsh KE, Kaushal R, Chessare JB. How to avoid paediatric medication errors: a user's guide to the literature. Arch Dis Child. 2005;90:698-702 (Pubitemid 40922499)
    • (2005) Archives of Disease in Childhood , vol.90 , Issue.7 , pp. 698-702
    • Walsh, K.E.1    Kaushal, R.2    Chessare, J.B.3
  • 55
    • 0004251988 scopus 로고    scopus 로고
    • Last J, ed 4th ed. New York NY: Oxford University Press, Inc
    • Last J, ed. A Dictionary of Epidemiology. 4th ed. New York NY: Oxford University Press, Inc;2001
    • (2001) A Dictionary of Epidemiology


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.