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Nurs Manage. 2005 Sep;36(9):24-30.

Best-practice protocols: preventing adverse drug events.

Author information

  • Stanford Hospital and Clinics, Stanford, CA, USA.

Abstract

Analysis of Stanford's electronic Patient Safety Net revealed a pattern of unrecognized, widespread, low-frequency I.V.-PCA adverse events. A performance improvement-failure modes and effects analysis identified causes, and a multidisciplinary team developed solutions.

PMID:
16155492
[PubMed - indexed for MEDLINE]
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