ECRI Institute, under contract with the Pennsylvania Patient Safety Authority, is responsible for the design, development, and implementation of the statewide Pennsylvania Patient Safety Reporting System (PA-PSRS).

These quarterly advisories provide patient safety recommendations based on reports submitted to PA-PSRS. Each issue highlights a specific topic, but also discusses several additional patient safety concerns.

2008

March: Diagnostic Ionizing Radiation and Pregnancy
Supplementary Advisory: Alarm Interventions During Medical Telemetry Monitoring; A Failure Mode & Effects Analysis

2007

December: Preventing Wrong-Site Surgery
September: Patient Safety Authority: Partners in risk management
June: Wrong-site surgery
Supplementary Advisory: Pharmacy computer system safety
Supplementary Advisory: Contrast-induced nephropathy
March: Airway fires during surgery

2006

December: Avoiding possibly fatal hip surgery complication
September: Preventing skin tears
Supplementary Advisory: Color-coded patient wristbands (update)
June: Telephone verbal order safety
March: Propofol administration

2005

December: Ambulatory surgery discharge
Supplementary Advisory: Color-coded patient wristbands
September: Lost surgical specimens
June: C. Difficile and antibiotic use
March: Patients as collaborators in safety

2004

December: Scissors safety
Supplementary Advisory: Insulin and tuberculin syringe mix-ups
September: Extravasation of radiologic contrast
June: Latex sources in healthcare