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High Alert Medications/LASA Drugs
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Transcript
High Alert Medications/LASA Drugs
Hope Kalajian
MAH Medication Safety Rotation
Why is this important?
Background
What are they?
- Many drug names can be confused for one another
- Foreign countries
- Proprietary/non-proprietary names
- Med errors are reported to the NCC MERP
- Retrospective study between 1993 and 1998 of 5,366 medication errors
- 41% of med errors --> wrong dose administered
- 16% of med errors --> wrong drug administered
- 10% of med errors --> wrong route of administration
- Costs the US economy hundreds of billion $$$ per year
- High alert medications can cause serious and irreversible harm to patients
- Insulin: hypoglycemia
- Adrenergic antagonists: bradycardia/hypotension
- Anti-thrombotic medications: bleeding
- Narcotics/Opioids: delirium
LASA --> "Look Alike Sound Alike" drugs
- Examples:
- Celebrex/Celexa
- Prilosec/Prozac
High Alert Medications --> Medications that can be more detrimental to patients if used in error
- Examples:
- Epinephrine
- Insulin
- Lidocaine
What can be done for the future?
"A positive step toward this end would be to incorporate visual communication design practices, and specifically typographic principles and legibility studies, in the production of packaging and labelling." - Sandra Gabriele
author of http://www.longwoods.com/content/18465
Safeguards
What is being done about this?
How do these errors occur?
- Electronic Technology
- Barcoding
- CPOE
- Pop-up alerts in the computer system
- TALL man lettering
- Typography
- Bold face/color coding
- Contrast
- Working with drug companies to improve packaging/labeling
- Separating LASA medications in storage area
- Poor handwriting on written orders
- Abbreviations
- Misunderstood verbal orders
- Failure to write both brand and generic on medication orders
- Similar manufacturer packaging
- FDA's Name Differentiation Project 2001
- TALL man lettering system
- ISMP's list of confused drug names and high alert medications
- Updated annually
- USP's Drug Error Finder 2008
- Public Education
- Implementing safeguards
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