National Patient Safety Foundation Patient Safety Literature Current Awareness Alert. Updated twice monthly on the NPSF website.

This twice-monthly publication from the National Patient Safety Foundation (NPSF) Information Center identifies articles of interest to the patient safety community. The publication pinpoints items of interest from a wide array of publications.

Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, Seger DL, Shu K, Federico F, Leape LL, Bates DW. Adverse drug events in ambulatory care. New England Journal of Medicine. 2003 Apr;17 348(16):1587-1589.

Adverse events related to drugs occur frequently among inpatients, and many of these events are preventable. However, few data are available on adverse drug events among outpatients. We conducted a study to determine the rates, types, severity, and preventability of such events among outpatients and to identify preventive strategies.

Wilke MH, Schenker M, Hoffmann G. Detection and documentation of DRG-relevant comorbidities using laboratory tests. Australian Health Review. 2002;25(3):152-160.

The Academic Teaching Hospital Munich-Schwabing in Munich decided to explore coding strategies by considering the impact of diagnoses that could be detected by pathology tests.

Cullen DJ, Bates DW, Small SD, Cooper JB, Nemeskal AR, Leape LL. The incident reporting system does not detect adverse drug events: A problem for quality improvement. Joint Commission Journal on Quality Improvement. 1995 Oct;21(10):541-548.

The objectives of this study were 1) to determine the frequency with which adverse drug events result in an incident report (IR) in hospitalized patients; and 2) to determine if there were differences between quality assurance administrators, nurse leaders in quality assurance, and staff nurses as to whether an incident report should or would be filed for each adverse drug event.

Chiquette E, Amato MG, Bussey HI. Comparison of an anticoagulation clinic with usual medical care: anticoagulation control, patient outcomes, and health care costs. Archives of Internal Medicine. 1998 Aug 10-24;158(15):1641-1647.

The outcomes of an inception cohort of patients seen at an anticoagulation clinic (AC) were published previously. The temporary closure of this clinic allowed the evaluation of 2 more inception cohorts: usual medical care and an AC.

Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF Jr, Lloyd JF, Burke JP. A computer-assisted management program for antibiotics and other antiinfective agents. New England Journal of Medicine. Jan 22;338(4):232-238.

Optimal decisions about the use of antibiotics and other antiinfective agents in critically ill patients require access to a large amount of complex information. We have developed a computerized decision-support program linked to computer-based patient records that can assist physicians in the use of antiinfective agents and improve the quality of care.

Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Archives of Internal Medicine. 1997 Jul 28;157(14):1531-1536.

This study updates and expands explicit criteria defining potentially inappropriate medication use by the elderly.

Thomas EJ, Lipsitz SR, Studdert DM, Brennan TA. The reliability of medical record review for estimating adverse event rates. Annals of Internal Medicine. 2002 June 4;136(11):I40.

The data used by the U.S. Institute of Medicine to estimate deaths from medical errors come from a study that relied on nurse and physician reviews of medical records to detect the errors.

Phillips KA, Veenstra DL, Oren E, Lee JK, Sadee W. Potential role of pharmacogenomics in reducing adverse drug reactions: a systematic review. Journal of the American Medical Association. 2001 Nov 14;286(18):2270-2279.

Adverse drug reactions are a significant cause of morbidity and mortality. Although many adverse drug reactions are considered nonpreventable, recent developments suggest these reactions may be avoided through individualization of drug therapies based on genetic information, an application known as pharmacogenomics.

Bates DW, Evans RS, Murff H, Stetson PD, Pizziferri L, Hripcsak G. Detecting adverse events using information technology. Journal of the American Medical Informatics Association. 2003 Mar-Apr;10(2):115-128.

Although patient safety is a major problem, most health care organizations rely on spontaneous reporting, which detects only a small minority of adverse events. As a result, problems with safety have remained hidden. Chart review can detect adverse events in research settings, but it is too expensive for routine use. Information technology techniques can detect some adverse events in a timely and cost-effective way, in some cases early enough to prevent patient harm.