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NCPS in Action
Note: This list of safety topics is not complete.
Please see Alerts, Topics in Patient Safety (TIPS) Newsletters, and view PowerPoint: Information
on Research Databases for additional information.
Hazard
Summaries |
Healthcare
Failure Mode and Effect Analysis |
Falls
Tool Kit |
Ensuring
Correct Surgery |
Hand Hygiene |
PSAT
Oxygen (Compressed Gas) Cylinder Hazard Summary
MR Hazard Summary
Anticoagulation Vulnerability
Glucometers
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References
- © Joseph DeRosier, PE, CSP; Erik Stalhandske, MPP, MHSA; James P. Bagian, MD, PE; Tina Nudell, MS: Using
Health Care Failure Mode and Effect Analysis™: The VA National Center for Patient Safety's Prospective Risk Analysis System. (PDF) (HTML)The
Joint Commission Journal on Quality Improvement Volume 27 Number 5:248-267, 2002. Posted with permission.
- Joint Commission Executive Briefings on the Patient Safety Standards: Designing Safer Health Care Systems. 2001. Joint
Commission Resources, pp 92-95.
- McDermott, Robin E., Raymond J. Mikulak, and Michael R. Beauregard. 1996. The Basics of FMEA. Portland, OR: Resources
Engineering, Inc.
- Stamatis, D.H. 1995. Failure Mode and Effect Analysis: FMEA from Theory to Execution. Milwaukee, WI: ASQ Quality Press.
- The Patient Safety Improvement Handbook, 2001. VHA National
Center for Patient Safety. Ann Arbor, MI.
- ISMP Sample Case for PCA Pump (Word)
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Many facilities are working to find ways to reduce the number
of falls as well as the severity of the falls that do occur.
In an effort to help facilities, we created the Falls Toolkit.
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VHA Directive 2004-028:
Ensuring Correct Surgery and Invasive Procedures
Supplemental Training Materials based on VHA Directive 2002-070
Course Evaluation and Continuing Education Credit
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Hand Hygiene Information and Tools - a collection of reference documents
and tools to help health care providers and others to understand and respond appropriately to: The CDC Guideline on Hand Hygiene
in Health Care Settings; the Joint Commission National Patient Safety Goal on Preventing Nosocomial Infections; and the VHA Directive on Hand
Hygiene Practices.
Hand Hygiene Information and Tools: Frequently Asked Questions
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The Patient Safety Assessment Tool (Excel) (PSAT) - a cognitive aid to assist managers and staff conduct an objective assessment of a patient safety program. The tool covers program administration and management and provides walk-around sections focusing on the patient care environment.
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National Center for Patient Safety