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How to Identify Organizational High-Alert Medications
Lotta Schepel, Lasse Lehtonen1, Marja Airaksinen
1University of Helsinki and Helsinki University Hospital.
Journal of Patient Safety
|July 12, 2018
Summary
Identifying high-alert medications requires hospital-specific data. Analyzing adverse drug reaction (ADR) and medication error (ME) reports helps customize safety lists for preventing patient harm.
Area of Science:
- Pharmacovigilance
- Medication Safety
- Health Informatics
Background:
- High-alert medications pose significant patient harm risks when errors occur.
- Tailoring high-alert medication lists to local hospital data is crucial for effective safety strategies.
Purpose of the Study:
- To identify organizational high-alert medications at a university hospital.
- To evaluate hospital-specific adverse drug reaction (ADR) and medication error (ME) data for this purpose.
Main Methods:
- Analysis of Anatomical Therapeutic Chemical (ATC) codes and active substances from ADR (n=401) and ME (n=11,668) reports (2015-2016).
- Comparison of hospital drug consumption data with the Institute for Safe Medication Practices (ISMP) high-alert medication list.
Main Results:
- Top ATC groups in ADRs (antineoplastic/immunomodulating agents) and MEs (nervous system agents) differed.
- Antineoplastic agents, antithrombotics, opioids, and insulins identified as high-alert medications based on ADR/ME data.
- Amphotericin B showed high ME rates relative to consumption, despite no reported ADRs.
Conclusions:
- Integrating drug safety (ADR) and medication safety (ME) data is essential for identifying organizational high-alert medications.
- Local data analysis, literature review, and expert input are necessary for comprehensive high-alert medication identification.
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