High Alert list revision

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jrufo@ismp.org

2 posts / 0 new
Last post
Rachel Durham
Rachel Durham's picture
Offline
Last seen: 3 weeks 4 days ago
Joined: 02/17/2020 - 22:00
High Alert list revision

Hi all.

I am working on revamping our High Alert medication policy and came up with a few questions...

1. Is digoxin included in your high alert med list? Do you require a nursing assessments prior to administering such as heart rate? dig level?

2. Do you require an administration co-signature (an independent 2nd check) for insuliln? Do you standardize how these independent 2nd checks are supposed to happen?

3. For long acting opioids, do you require any documentation (either provider or pharmacist) regarding whether or not the patient is opiate tolerant or naive? (I think this question was included in a recent ISMP survey).

4. For PPNs and TPNs, do you require an administration cosignature? If so, what is the nurse cosigning for? (our TPNs/PPNs are very low volume and we use Clinimix with or without additional components).

5. Do you do any additional process when administering a sulfonylurea like an Accucheck or maybe a cosignature, like we have with insulin.

Thanks in advance for your feedback :)

Rachel Durham