"Latent and active failures perfectly align to allow a preventable adverse event to reach a patient"

January 26 - Vol. 28 Issue. 2
"ISMP updates its list of drug names with tall man (mixed case) letters based on survey results"

February 9 - Vol. 28 Issue. 3
"Pump up the volume: How to prioritize events and analyze error data"

February 23 - Vol. 28 Issue. 4
"Controlled substance drug diversion by healthcare workers as a threat to patient safety—Part I"

March 9 - Vol. 28 Issue. 5
"Controlled substance drug diversion by healthcare workers as a threat to patient safety—Part II"

March 23 - Vol. 28 Issue. 6
"Implement strategies to prevent persistent medication errors and hazards"

April 6 - Vol. 28 Issue. 7
"Safety considerations during expedited product approval"

April 20 - Vol. 28 Issue. 8
"Ensuring competency and safety when onboarding newly hired professional staff–Part I"

May 4 - Vol. 28 Issue. 9
"The role of simulation when onboarding healthcare professionals—Part II"

May 18 - Vol. 28 Issue. 10
"Smart infusion pump investigations after an unexplained over-infusion"

June 1 - Vol. 28 Issue. 11
"Taking a closer look at medication errors that involve oxytocin"

June 15 - Vol. 28 Issue. 12
"Assessing medication safety in settings not designated solely for pediatric patients"

June 29 - Vol. 28 Issue. 13
"A hard look at hard stops and workarounds in the acute care setting"

July 13 - Vol. 28 Issue. 14
"Proper deployment of REMS to reduce potential drug-related harm and medication errors—Part I"

July 27 - Vol. 28 Issue. 15
"Incorporating REMS program requirements into systems and processes—Part II"

August 10 - Vol. 28 Issue. 16
"Safety issues with long-acting injectable (LAI) antipsychotics"

August 24 - Vol. 28 Issue. 17
"Obstetrical patient receives ampule of digoxin instead of BUPivacaine for spinal anesthesia"

September 7 - Vol. 28 Issue. 18
"Drug, supply, and equipment shortages continue to compromise patient care"

September 21 - Vol. 28 Issue. 19
"Patient death tied to lack of proper escalation process for barcode scanning failures"

October 5 - Vol. 28 Issue. 20
"Minimizing distractions and interruptions during medication safety tasks"

November 5 - Vol. 28 Issue. 22
"IV push medications—Bridging the gap between education and clinical practice"

November 16 - Vol. 28 Issue. 23
"Why "benchmarking" error rates is NEVER a good measure of performance or patient safety"

November 30 - Vol. 28 Issue. 24
"Patients with low health literacy make more errors interpreting instructions and warnings"

December - Vol. 28 Issue. 25
"ISMP Cheers Awards"