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Through an Interprofessional Root Cause Analysis of this Near Miss event, we aimed to: 1.Identify issues contributing to the incorrect dosing of acyclovir 2.Understand relevant institutional policies and compare this to usual practice 3.Propose possible solutions
The Case of the 10 Pound Giant: A Near Miss Root Cause Analysis
Medicine and Health Sciences
Chen, MD, Debbie; Margiotta, MD, Megan; and Turner, MD, Grant, "The Case of the 10 Pound Giant: A Near Miss Root Cause Analysis" (2017). House Staff Quality Improvement and Patient Safety Posters. Poster 24.