In this section :
- Hospital harm is everyone’s concern
-
Hospital Harm Improvement Resource
- How to Use the Hospital Harm Measure for Improvement
- Learning from Harm
- General Patient Safety Quality Improvement and Measurement Resources
- Hypoglycemia: Introduction
- Aspiration Pneumonia: Introduction
- Delirium: Introduction
-
Infusion, Transfusion and Injection Complications: Introduction
- Infusion, Transfusion and Injection Complications: Discharge Abstract Database
- Infusion, Transfusion and Injection Complications: Importance to Patients and Families
- Infusion, Transfusion and Injection Complications: Clinical and System Reviews, Incident Analyses
- Infusion, Transfusion and Injection Complications: Measures
- Infusion, Transfusion and Injection Complications: Success Stories
- Infusion, Transfusion and Injection Complications: References
- Medication Incidents: Introduction
- Obstetric Hemorrhage: Introduction
- Patient Trauma: Introduction
- Pneumonia: Introduction
- Pneumothorax: Introduction
-
Post Procedural Infections: Introduction
- Post Procedural Infections: Discharge Abstract Database
- Post Procedural Infections: Importance to Patients and Families
- Post Procedural Infections: Clinical and Systems Reviews, Incident Analyses
- Post Procedural Infections: Measures
- Post Procedural Infections: Success Stories
- Post Procedural Infections: References
- Pressure Ulcer: Introduction
- Sepsis: Introduction
- UTI: Introduction
- Venous Thromboembolism: Introduction
- Wound Disruption: Introduction
- Obstetric Trauma: Introduction
-
Procedure-Associated Shock: Introduction
- Procedure-Associated Shock: Discharge Abstract Database
- Procedure-Associated Shock: Importance to Patients and Families
- Procedure-Associated Shock: Clinical and System Review, Incident Analysis
- Procedure-Associated Shock: Measures
- Procedure-Associated Shock: Success Stories
- Procedure-Associated Shock: References
- Selected Serious Events: Introduction
-
Electrolyte and Fluid Imbalance: Introduction
- Electrolyte and Fluid Imbalance: Discharge Abstract Database
- Electrolyte and Fluid Imbalance: Importance to Patients and Families
- Electrolyte and Fluid Imbalance: Clinical and System Reviews, Incident Analyses
- Electrolyte and Fluid Imbalance: Measures
- Electrolyte and Fluid Imbalance: Success Stories
- Electrolyte and Fluid Imbalance: References
-
Anemia – Hemorrhage (Health Care / Medication Associated Condition): Introduction
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): Discharge Abstract Database
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): Importance to Patients and Families
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): Clinical and System Reviews, Incident Analyses
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): Measures
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): Success Stories
- Anemia – Hemorrhage (Health Care / Medication Associated Condition): References
-
Anemia – Hemorrhage (Procedure-Associated Conditions): Introduction
- Anemia – Hemorrhage (Procedure-Associated Conditions): Discharge Abstract Database
- Anemia – Hemorrhage (Procedure-Associated Conditions): Importance to Patients and Families
- Anemia – Hemorrhage (Procedure-Associated Conditions): Clinical and System Reviews, Incident Analyses
- Anemia – Hemorrhage (Procedure-Associated Conditions): Measures
- Anemia – Hemorrhage (Procedure-Associated Conditions): Success Stories
- Anemia – Hemorrhage (Procedure-Associated Conditions): References
- Birth Trauma: Introduction
- Device Failure: Introduction
-
Infections due to Clostridium difficile, MRSA or VRE: Introduction
- Infections due to Clostridium difficile, MRSA or VRE: Discharge Abstract Database
- Infections due to Clostridium difficile, MRSA or VRE: Importance to Patients and Families
- Infections due to Clostridium difficile, MRSA or VRE: Surveillance, Outbreak Management
- Infections due to Clostridium difficile, MRSA or VRE: Clinical and System Reviews, Incident Analyses
- Infections due to Clostridium difficile, MRSA or VRE: Measures
- Infections due to Clostridium difficile, MRSA or VRE: Success Stories
- Infections due to Clostridium difficile, MRSA or VRE: References
- Laceration: Introduction
- Retained Foreign Body: Introduction
-
Viral Gastroenteritis: Introduction
- Viral Gastroenteritis: Discharge Abstract Database
- Viral Gastroenteritis: Importance to Patients and Families
- Viral Gastroenteritis: Surveillance, Outbreak Management
- Viral Gastroenteritis: Clinical and System Reviews, Incident Analyses
- Viral Gastroenteritis: Measures
- Viral Gastroenteritis: Success Stories
- Viral Gastroenteritis: References
Retained Foreign Body: References
Canadian Institute for Health Information (CIHI). Canada continues to lag behind other OECD countries on measures of patient safety. Ottawa, ON: CIHI. 2019a. https://www.cihi.ca/en/canada-continues-to-lag-behind-other-oecd-countries-on-measures-of-patient-safety?utm_medium=email&utm_source=crm&utm_campaign=stakeholder-embargo-oecd-embargo-october-2019&utm_content=canada-continues-to-lag-oecd-patient-safety-web-page-en&emktg_lang=en&emktg_order=3
Canadian Institute for Health Information (CIHI). OECD Interactive Tool: International Comparisons. Published 2019b. http://www.cihi.ca/en/oecd-interactive-tool-international-comparisons-patient-safety
Canadian Medical Protective Association (CMPA), Healthcare Insurance Reciprocal of Canada (HIROC). Detailed Analysis. Surgical Safety in Canada: A 10-Year Review of CMPA and HIROC Medico-Legal Data. 2016.
Canadian Patient Safety Institute (CPSI). Retained Foreign Object. Published 2016. https://www.patientsafetyinstitute.ca/en/Topic/Pages/Retained-Foreign-Object.aspx
Canadian Patient Safety Institute (CPSI). Surgical error inspires doctor to champion the safety of all patients. Published 2016.
Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk Factors for Retained Instruments and Sponges after Surgery. N Engl J Med. 2003;348(3):229-235. doi:10.1056/NEJMsa021721.
Gentile D. "It felt like I had been stabbed," says patient left with 33-cm metal plate inside after surgery. CBC News. Published June 28, 2017. https://www.cbc.ca/news/canada/montreal/montreal-hospital-instrument-left-inside-patient-sylvie-dube-1.4181278
Healthcare Insurance Reciprocal of Canada (HIROC). Risk Reference Sheets: Retained Surgical Items. Toronto, ON: HIROC; 2016. https://www.hiroc.com/resources/risk-reference-sheets/retained-surgical-items
Hôpital Charles LeMoyne. Leading Practices: Surgical Instruments Management Program. Ottawa, ON: Health Standards Organization; 2009. https://healthstandards.org/leading-practice/surgical-instruments-management-program/
Institute for Healthcare Improvement (IHI). How-to Guide: Prevent Harm from High-Alert Medications. Cambridge, MA: Institute for Healthcare Improvement (IHI); 2012. http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventHarmfromHighAlertMedications.aspx
Leung W. Canada worse than other wealthy countries in patient safety – including objects left in body after surgery, data show. The Globe and Mail. Published November 7, 2019. https://www.theglobeandmail.com/life/health-and-fitness/article-canada-worse-than-other-wealthy-countries-in-patient-safety/
Pennsylvania Patient Safety Authority. Epidural or Subarachnoid Catheter Shear. Pa Patient Saf Auth. 2009;6(3):84-86. Retrieved from: http://patientsafety.pa.gov/ADVISORIES/Pages/200909_84.aspx
Pugel AE, Simianu VV, Flum DR, Patchen Dellinger E. Use of the surgical safety checklist to improve communication and reduce complications. J Infect Public Health. 2015;8(3):219-225. doi:10.1016/j.jiph.2015.01.001
The Joint Commission. Preventing unintended retained foreign objects. Sentin Event Alert. 2013;(51). http://www.jointcommission.org/assets/1/6/SEA_51_URFOs_10_17_13_FINAL.pdf.
Weinstein SM, Hagle ME. Plumer's Principles and Practice of Infusion Therapy. Ninth. Philadelphia, PA: Lippincott Williams & Wilkins; 2014.
Retained Foreign Body
