Indicating on a pre-populated list obtained from an external source which medications are available for administration. Neuromuscular blocking agents.
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Eliminate the Possibility of Error.
. High Alert Medication List HEBHK No Category Medications 1. Cobra Antivenom Inj 3. Considered a class of high-alert medications.
Based on local medication error data the National Medication Safety Committee NMSC identified 5 core HAMs with the highest numbers of locally reported errors and issued an advisory to inform PHIs of the core HAM categories on 3 February 2021. However this is just the first step in safeguarding the use of high-alert medications. The APINCH classification is not an exhaustive list.
APINCHS Classification of High Risk Medicines. Adrenergic agonists IV Adrenaline Epinephrine 1 in 1000 1mgml Inj Noradrenaline Norepinephrine 4mg4ml Inj Phenylepherine 10mgml Inj Ephedrine 30mgml Inj 2. Categories of High Alert Medications 1.
Adrenaline 1mgml Inj 2. High-alert medications in long-term care include the following. Nitroprusside sodium for injection.
Adrenergic agonists IV eg EPINEPH rine phenylephrine norepinephrine. Percentage of Reported High Alert Medication Events 24 during 2017 at KAMC Riyadh 23 during 2016 at KAMC Riyadh Common Risks LASA Morphine and HYDROmorphone Lack of leading zero Ordered 8 mg patient received 8 mg Morphine Bolus dose failing to re-program maintenance dose Different rates and concentrations. This section includes information and resources about.
Drug Class and Medication Selection and Procurement Storage Ordering Verifying and Transcribing Preparing or Compounding Administration Monitoring. Organizations are required to implement a comprehensive strategy to manage high- alert medications based on the ISMP list of high-alert. Medication Safety Tools and Resources.
Reduce the number of concentrations and volumes. Dextrose 30 Inj 4. HIGH ALERT auxiliary labels on bags or bottles Use of SmartPumps for infusions with volumes and hard limits for doses and concentrations.
LIST OF HIGH ALERT MEDICATION THAT ARE AVAILBLE HBUK 1. High Alert Medications HAMs are medications that bear a heightened risk of causing significant patient harm when these medications are used in error. Although any medication used improperly can cause harm high-alert medications such as anticoagulants narcotics and opiates insulins and sedatives cause harm more commonly and the harm they produce is likely to be more serious and leads to patient suffering and additional costs associated with care of these patients.
High-alert and Hazardous medications. Anti-thrombotic agents anticoagulants DOAC factor Xa inhibitors direct thrombin inhibitors and thrombolytics Anticoagulants. These specific medications have been singled out for special emphasis to bring attention to the need for distinct strategies to prevent the types of errors that occur with these medications.
Example of a Hazardous medication. 4 Based on national reports of harm to patients we believe it. Examples include neuromuscular blocking agents digoxin antipsychotics and oral hypoglycaemics.
Insulin U-500 special emphasis. Practical for all of the medications on the list. High Alert High Risk Medications 2020-2022.
Reduce the number of drugs on a facilitys formulary. Other medicines or classes of medicines may also present a high risk. Standardizing the ordering storage preparation and administration of these.
Strategies for the effective management of high-alert medications include the following. Adrenergic antagonists IV Propanolol 1mgml Inj Labetalol 25mg5ml Inj. Digoxin 05mg2ml Inj 6.
Dextrose 50 Inj 5. For all of the medications on the list. Insulin U-500 has been singled out for special emphasis to bring attention to the need for distinct strategies to prevent the types of errors that occur with this concentrated form of insulin.
Adrenergic agonists IV eg epinephrine phenylephrine norepinephrine Adrenergic antagonists IV eg propranolol metoprolol labetalol Anesthetic agents general inhaled and IV eg. Organizations determine how staff and practitioners will be educated regarding processes for managing these medications. The ISMP is relying on ambulatory-care and community settings to use this updated list as a resource to identify the high-alert medications prescribed stored dispensed andor administered in their organizations or the facilities they serve.
Examples of High-alert medications. The healthcare facilities should review the list and identify their own individual list of HAMs. Specific Medications colchicine injection epoprostenol Flolan IV insulin subcutaneous and IV magnesium sulfate injection methotrexate oral non-oncologic use oxytocin IV nitroprusside sodium for injection potassium chloride for injection concentrate potassium phosphates injection promethazine IV.
Dobutamine 250mg20ml Inj 7. Developing separate lists for medications identified as high-alert andor hazardous. Medication Safety Alerts and Notices.
Remove high-alert drugs from critical areas. CATEGORIES OF HIGH ALERT MEDICATIONS All medications categorized in Table 1 are examples categories of High Alert Medications HAMs although it may not be listed individually in this guideline. EPINEPH rine IM SC.
Dopamine 200mg5ml Inj 8. NCPS promotes three principles to improve high-alert medication administration and distribution. All oral and parenteral chemotherapy and all insulins are considered high-alert medications.
Sodium Chloride 234 Hypertonic Saline PARENTERAL USE Removed from all patient care areas EXCEPT in ICU and OR Omnicells with specific criteria approved by PT. Warfarin Coumadin Lovenox enoxaparin Methotrexate Rheumatrex Trexal Fentanyl Patch Duragesic Hydrocodone with Acetaminophen Vicodin Lorcet Oxycodone with Acetaminophen Percocet Roxicet Apidra insulin glulisine Humalog insulin lispro Lantus insulin glargine.
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