PHC High Alert Medications

HIPPOS What are they? (Besides animals)

PHC High Alert Medications

High alert medications are medications that are most likely to cause significant harm to the patient, even when used as intended. intended

PHC High Alert Medications

H = Heparin & Antithrombotic Agents

Standards in Place as Safeguards:
Limited access Limited concentrations available, prepared and stocked Standardized order sets Standardized protocols and monitoring guidelines Specific examples: alteplase protocol for stroke, pharmacy dosing and monitoring protocols for heparin, warfarin and enoxaparin

PHC High Alert Medications

I = Insulin
Standards in Place as Safeguards:
Standard concentrations and products Standard glycemic control policies New standards for diabetic order sets New diabetic order sets Standardized hypoglycemia protocol Specific examples: Pyxis access to agents for hypoglycemia, use of Glucommander for IV therapy management, implementation of consistent process for correctional scale use

PHC High Alert Medications

P = Potassium, magnesium and other concentrated electrolytes

Standards in Place as Safeguards:
Standardized order sets Administration guidelines Limited access to products Specific examples: general distribution and labeling of all products from pharmacy, premixed standard magnesium sulfate infusions for labor and delivery, policy regarding use and administration of potassium infusions

PHC High Alert Medications

P = Paralyzing Agents
(succinylcholine, etomidate, rocuronium, etc.)

Standards in Place as Safeguards:

Limited access to products Standardized concentrations Dosing guidelines Specific examples: rapid sequence intubation kit (standardizes product selection and security process for emergency use), standardized labeling with use of additional auxiliary stickers

PHC High Alert Medications

O = Opiates
Standards in Place as Safeguards:
PCA pumps (Min & Max Dosage Limits) Standard concentrations of products Double checks/ independent verification when PCA used Pain monitoring and documentation standards Specific examples: standardized epidural labeling with use of additional auxiliary stickers, Pyxis security, control and double checks, policies to guide type and location of procedural sedation and anesthesia

PHC High Alert Medications

S = Special procedure items:

chemotherapy, contrast, and anesthetics
Standards in Place as Safeguards:
Standard medication administration guidelines Limited access Standard protocols Specific examples: o Contrast: limited access and specific ordering protocols through radiology o Chemotherapy: multidisciplinary independent verification/ double checks of orders and products o Anesthetic agents: limited access, limited use and policies that oversee product use

PHC High Alert Medications

These slides were created to educate staff on high alert medications to enhance patient safety within our organization
Prepared by Ronelle Christenson (OMH) and Karen Smith (WMH) May 2007 PCEC