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Knowledge Repository

Light for patient safety: Impact of light on reading errors of medication labels

Author(s): Aarts, M. P. J., Craenmehr, G., Rosemann, A. L. P., van Loenen, E. J., Kort, H. S. M.
Added August 2020

A socio-technical and Lean approach towards a framework for Health Information Systems-induced error

Author(s): Yusof, M. M., Lau, F., Bartle-Clar, J. A., Bliss, G., Borycki, E. M., Courtney, K. L.
Added August 2020

Medication error trends and effects of person-related, environment-related and communication-related factors on medication errors in a paediatric hospital

Author(s): Manias, E., Cranswick, N., Newall, F., Rosenfeld, E., Weiner, C., Williams, A., Wong, I. C. K., Borrott, N., Lai, J., Kinney, S.
Added August 2020

The Architecture Of Safety: An Emerging Priority For Improving Patient Safety

Author(s): Joseph, A., Henriksen, K., Malone, E.
Added December 2018

Effects of noise on errors, injuries and subjective health of nursing staff

Author(s): Smith, A.
Added October 2017

A Novel ICU Hand-Over Tool: The Glass Door of the Patient Room

Author(s): Wessman, B. T., Sona, C., Schallom, M.
The Institute of Medicine has identified poor communication among the patient care team as one of the most common causes of serious errors in patient care. There was a desire in this organization to create a culture of team-oriented continuity of care by changing the mindset of handoff reporting to handover reporting communication among multidisciplinary care team members on key aspects of the patient’s daily plan of care. They developed a communication tool that included key areas of care (tests, care goals and progress toward those goals, treatments, and consultation recommendations) and printed the topic areas on the glass door of the patient room. The information was updated regularly throughout the day/night so that the most current information on patient status was available any time for rounding by various care providers, specialists, and consultants. The information was also available for viewing by the patient’s family.
Key Point Summary
Added August 2020

Alert Workplace From Healthcare Workers’ Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings

Author(s): Zadeh, R. S., Shepley, M., Sadatsafavi, H., Owora, A. H., Krieger, A. C.
Added August 2020

Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study

Author(s): Huckels-Baumgart, S., Baumgart, A., Buschmann, U., Schüpfer, G., Manser, T.
Errors and interruptions are commonplace during medication preparation procedures in healthcare environments. One study found that one interruption occurred for every 3.2 drugs administered during nurses’ medication rounds.
Key Point Summary
Added August 2020

Safer anaesthetic rooms: Human factors/ ergonomics analysis of work practices

Author(s): Davis, M., Hignett, S., Hillier, S., Hames, N., Hodder, S.
Added November 2018

One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

Author(s): Maben, J., Griffiths, P., Penfold, C., Simon, M, Anderson, J. E., Robert, G., Pizzo, E., Hughes, J., Murrells, T., Barlow, J.
Authors indicate that despite the trend to adopt single-patient rooms, there is a dearth of strong evidence regarding its effect on healthcare quality and safety. When a hospital in England moved to a new building with 100% single rooms, a before-and-after move study was conducted on patient and staff experience, safety outcomes, and cost analysis. The study found that over two-thirds of the patients and one-fifth of the staff preferred single rooms.
Key Point Summary
Added September 2017