High-alert medication safety

Improve the safety of using high-alert medications, such as removing concentrated electrolytes (including, but not limited to, potassium chloride, potassium phosphate, sodium chloride >0.9%) from patient care units. 

JCAHO Sentinel Event Alert No. 11 High-alert medications and patient safety, November 19, 1999. Available at www.jcaho.org, accessed August 5, 2002. JCAHO Sentinel Event Alert No. 15 Infusion pumps — preventing future adverse events, November 3, 2000. Available at www.jcaho.org, accessed August 5, 2002. 

High-alert medications and patient safety. Sentinel Event Alert 11 (Nov 19) 1999. 

Improve the safety of using high-alert medications... 

The aim of this example of risk assessment is to assess the risks in order to prioritise measures to improve safety of reconstitution on the ICU ward [3]. Two hazards of reconstitution of parenteral medicines admixtures are focussed upon microbial contamination (in fact loss of sterility) and faulty composition. The probability of microbial contamination and faulty composition is related to the number of steps during the process that are critical for microbial contamination (see Sect. 31.3.2) or faulty composition respectively. The number of critical steps are multiplied by 2 if the medicine is mentioned in the Institute for Safe Medication Practices (ISMP) list of high-alert medications [4]. In this way the severity in case of faulty composition is taken into account. 

List four key safety suggestions related to high-alert medications. 

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