Marlene R. Miller

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CONTEXT Although medical injuries are recognized as a major hazard in the health care system, little is known about their impact. OBJECTIVE To assess excess length of stay, charges, and deaths attributable to medical injuries during hospitalization. DESIGN, SETTING, AND PATIENTS The Agency for Healthcare Research and Quality (AHRQ) Patient Safety(More)
CONTEXT Inappropriate medication use is a major patient safety concern, especially for the elderly population. Using explicit criteria, prior studies have found that 23.5% and 17.5% of the US community-dwelling elderly population used at least 1 of 20 potentially inappropriate medications in 1987 and 1992, respectively. OBJECTIVES To determine the(More)
OBJECTIVE To investigate whether a multidisciplinary, best-practice central line maintenance care bundle reduces central line-associated blood stream infection (CLABSI) rates in hospitalized pediatric oncology patients and to further delineate the epidemiology of CLABSIs in this population. METHODS We performed a prospective, interrupted time series study(More)
OBJECTIVE Our objective was to describe potential patient safety events for hospitalized children, using the patient safety indicators (PSIs), and examine associations with these events. METHODS PSI algorithms, developed by researchers at the Agency for Healthcare Research and Quality to identify potential in-hospital patient safety problems using(More)
Measures based on routinely collected data would be useful to examine the epidemiology of patient safety. Extending previous work, we established the face and consensual validity of twenty Patient Safety Indicators (PSIs). We generated a national profile of patient safety by applying these PSIs to the HCUP Nationwide Inpatient Sample. The incidence of most(More)
The technology of intravenous catheter access ports has evolved from open ports covered by removable caps to more-sophisticated, closed versions containing mechanical valves. We report a significant increase in catheter-related bloodstream infections after the introduction of a new needle-free positive-pressure mechanical valve intravenous access port at(More)
OBJECTIVES To study the effect of an intervention on prevention of respiratory arrest and cardiopulmonary arrest (CPA) and to characterize ward CPAs by preceding signs and symptoms and initial cardiac rhythm. DESIGN A before-and-after interventional trial (12 months preintervention and 12 months postintervention). SETTING A tertiary care, academic(More)
OBJECTIVE Despite the magnitude of the problem of catheter-associated bloodstream infections (CA-BSIs) in children, relatively little research has been performed to identify effective strategies to reduce these complications. In this study, we aimed to develop and evaluate effective catheter-care practices to reduce pediatric CA-BSIs. STUDY DESIGN AND(More)
BACKGROUND Although children are at the greatest risk for medication errors, little is known about the overall epidemiology of these errors, where the gaps are in our knowledge, and to what extent national medication error reduction strategies focus on children. OBJECTIVE To synthesise peer reviewed knowledge on children's medication errors and on(More)
OBJECTIVE To develop Patient Safety Indicators (PSI) to identify potential in-hospital patient safety problems for the purpose of quality improvement. DATA SOURCE/STUDY DESIGN The data source was 2,400,000 discharge records in the 1997 New York State Inpatient Database. PSI algorithms were developed using systematic literature reviews of indicators and(More)