Safety matters: High-risk or high-alert medications reminder

High-alert medications have a higher risk of causing significant patient harm when used in error. Medications that Pharmacy and the Therapeutics Committee have deemed high-risk or high-alert include these categories, designated by the acronym HEROICS:

• Heparin and other anticoagulants and antithrombotics (e.g., alteplase)
• Epidurals (patient-controlled epidural analgesia) and epoprostenol/prostacyclin analogues for pulmonary hypertension (parenteral and inhaled)
• Rocuronium and other neuromuscular blocking agents
• Opioids, oxytocin IV and oncology including biologic, chemotherapy and target therapy IV and oral agents
• Insulin IV bolus or continuous infusion and U-500 Pen
• Concentrated electrolytes and TPN
• Sound-alike/look-alike medications

YNHHS strategies to mitigate risk include:

• Limiting available concentrations
• Ready-to-administer products
• Limiting access
• Tall man lettering
• IV barcode technology
• Independent dual verification
• Smart pump technology
• Prescribing guidelines in the electronic medical record
• Restricting authorized prescribers

For more information (including strategies used for each category of drugs), refer to the YNHHS High Risk/Alert Medication Policy.