Please enable JavaScript.
Coggle requires JavaScript to display documents.
High Alert Medication - Coggle Diagram
High Alert Medication
-
COMMON RISK FACTORS
- Different route of administration
- Wrong infusion rate
- Incorrect preparation of drug
- Look Alike Sound Alike (LASA)
- Misinterpretation of medications order
- Availability of products variation
- Ambiguous labelling
MEDICATION MANAGEMENT PROCESS: ERROR PREVENTION STRATEGIES TO
IMPROVE THE SAFETY OF HIGH ALERT MEDICATIONS
Procurement
- Limit the medication strengths available in the formulary of each healthcare facility.
- Encourage the purchase of equipment and consumables with safety features for safe medication administration. i.e. oral syringes; pumps with locking mechanism.
- Avoid frequent changes of brand or colour. Notify the end users whenever there are changes.
Storage
- Use cautionary label/label enhancement on packages and storage bins of identified high alert medication.
- All high alert medications should be kept in individual labeled containers. Avoid look-alike and sound-alike medications or different strengths of the same medication from being stored side by side. Use TALL-man lettering to emphasize differences in medication names
- Limit the ward’s floor stock medications to the standard requirement. Reduce the quantity and variation of strength/preparation stocked. All personnel must read the HIGH ALERT MEDICATION labels carefully before storing to ensure medications are kept at the correct place
Prescribing
- Use standardized forms for written orders of cytotoxic medications and parenteral nutrition
- Do not use abbreviation/acronym and Specify clearly the dose, route and rate of infusion for high alert medication prescribed.
- Prescribe oral liquid medications with the dose specified in milligrams. Use leading zero and no trailing zero.
- Use generic name and always take note of body weight and BSA for specific medications
Preparation
- Establish a counterchecking system for all preparations involving high alert medication.
- Calculation involving CDR and Extemp profucts which must be independently counterchecked
- All diluted medications MUST BE LABELED with the name and strength immediately upon
dilution.
Dispensing
- All high alert medication containers, product packages or loose vials/ampoules issued to
wards/units must be labeled as HIGH ALERT MEDICATION.
- High alert medications to be dispensed to patients need not be labeled as high alert.
- High alert medications must be counterchecked before dispensing.
- High alert medications shall be checked upon receiving by the healthcare professionals.
Administration
- The following particulars shall be independently counterchecked against the prescription or
medication chart at the bedside by two appropriate persons before administration:
- patients identification
- Name, dose and strength of drug
- Route and rate (if any)
- expiry date
Line attachment (if any)
- Label the distal ends of all access lines to distinguish IV from epidural lines
- Ensure no distraction during the administration of medications to patients by implementing special
measures (Example: wearing special vest).
- Return all unused or remaining specially formulated preparations to the pharmacy when no longer required.
- Ensure administration of intrathecal, cytotoxic medications, epidural analgesics and
parenteral nutrition is done by trained personnel.
Monitoring
- Closely monitor and document vital signs, laboratory data, patient’s response before and after
administration of high alert medications.
- Keep antidotes and resuscitation equipment in wards/emergency room/units.
Documentation
- 2 more items...
Definition
medications that bear a heightened risk of causing significant patient harm when these medications are used in error
Example of HAM:
- Opioid (IV, Oral, Transdermal etc)
- Antivenom
- IV Adrenergic agonist
- IV Adrenergic antagonist
- Antivenom
- CDR
- Neuromuscular blocking agents
- Immunosuppressant agents
MANAGEMENT OF HIGH ALERT MEDICATIONS:
- List of high alert medications used within the facility shall be identified.
- High alert medications should have HIGH ALERT MEDICATION labels on storage shelves, containers, product packages OR loose vials/ ampoules.
- Any changes of brand/colour/preparation of high alert medications must be informed to the users as soon as possible.
- Review and evaluate the checklist for high alert medications in Medication Safety Self – Assessment Form
- Keep apart look alike sound alike of high alert medications.
- Monitor and report adverse drug reaction and medication error related to high alert medications.