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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.