international patient safety goals 3-4

PPG’S
REVIEW
Jamilah saad Alqahtani
CNS,MSN,NS,RGN,BSN, OR Specialist

Objectives
At the end of this lecture participants will be
review the following:
1. Improving safety of high alert medications at
AFHSR IPSG3
2. Storage, handling of concentrated
electrolytes & Error prevention strategies at
AFHSR IPSG 3.1
3. AFHSR Look Alike_Sound Alike medication
management IPSG3.1.1
4. Correct-site, Correct-procedure, Correct-
patient Surgery IPSG-004
CNS,MSN,NS,RGN,BSN, OR Specialist 07.05.2018OR AFHSR

Improving Safety Of High Alert Medication
At AFHSR IPSG3

High Alert Medications Policies
• High Alert Medications (HAM) are drugs that
involveand labeling or clinicaluse, look alike ar sound
alike are prone to medication errors.
• Independentdouble checking A procedure in which
two healthcareprofessionals separately verify (alone
and apart from each other the compare results ) a
medication thatis about to be dispensed / administrated
to patient

High Alert Medications polices
AFHSR pharmacy department develop Lists of high alert medications includes the following:
1. Narcotic& controlled medications (AFHSR-MMU-PH-P01-5TH Edition)
2. Neuromuscular blockers (AFHSR-MMU-PH-P01-5TH Edition)
3. Antineoplastic medications (AFHSR-MMU-PH-P07-1st Edition)
4. Concentrated electrolytes(AFHSR-MMU-PH-P02-3TH Edition)
5. Antithrombotic medications (AFHSR-MMU-PH-P01-5TH Edition)
6. Look Alike drugs (AFHSR-MMU-PH-P01-5th Edition)
7. Sound Alike Drugs (AFHSR-MMU-PH-P03-6th Edition)
8. Radio-contrast agent -(AFHSR-MMU-PH-P09-3rdEdition)
9. Insulins (AFHSR-MMU-PH-P01-5TH Edition)
10. Anesthetic medication (AFHSR-MMU-PH-P01-5TH Edition)
11. Total parenteral nutrition (AFHSR-MMU-PH-P01-5TH Edition)
12. Other medications as identified by AFHSR (AFHSR-MMU-PH-P01-5TH Edition)

High Alert Medications Policies (cont.)
Examples are…….

High Alert
Medications
Policies (cont.)
For All HAM : Stored in a lock and key
cabinet.
Prescribed and
administered with care.
Ensure to double check
during calculations and
administration.
Designated place to
store under the
supervision of senior
/Incharge staff of the
department.
Name tags of HAM in
Pharmacies should
clearly state (High Alert
Medication: Double
check)
CNS,MSN,NS,RGN,BSN, OR Specialist 07.05.2018
OR AFHSR

High Alert Medications Policies
 Concentrated electrolytes solutions shall be stored in
critical care areas labels with blue color stickered for
proper identification.

• All staff working with medication responsible to be oriented to avoid
errors
• If nursing staff have any doubt in calculations or compatibilities ( refer
to IV guide lines AFHSR-MMU-PH-F10,F86,F88-3RD Edition) or they
must contact treating physician, IV pharmacist bleep00261
• Verbal & telephone orders is allowed in emergency cases at critical
care areas and later must be documented within 24hrs

• Standing orders are allowed at critical care areas as per the PPG-
AFHSR-MMU-27
• In case of emergency situation where electrolyte correction is required
at non critical words it can be barrowed from the nearest critical care
ward only allowed when patient condition cannot be compromised
CNS,MSN,NS,RGN,BSN, OR Specialist
07.05.2018OR AFHSR

AFHSR Look Alike- Sound Alike
Medication Management
IPSG3.1.1

Look Alike/ Sound Alike Medications
• LA medication are visually similar in appearance/packaging
• SA medication are spelling similarity or similar phonetics
• Tall Man lettering is the practice of writing part of a medicines name
in upper case letters to help distinguish sound A like medications from
one another and a void errors
( e.g HydrOXYzine and hydrALAZINE )

Look Alike/ Sound Alike Medications(cont.)

(cont.)
• All medications included in LA, SA lists
must have yellow labels stating look
Alike/sound Alike
• In event of unavailability of yellow labels
yellow color adhesive tape stickers, labels,
or bins can be used for proper
identification
• LASA medications must not be accepted
by nursing staff if there is no label affixed
by the pharmacy

Look Alike/ Sound Alike Medications polices
Hospital takes actions to prevent errors involving LASA medications
including the following as applicable:
1. Providing education to healthcare professionals at orientation and as
part of continuing education
2. Writing the diagnosis/ indication on prescription
3. Changing the appearance of look alike medications
4. Using TALL man lettering for sound Alike medications
5. Reading carefully the label before each time prior to administration
6. Minimizing the use of verbal and telephone orders
7. Checking the indication of medication on prescription prior to dispensing
& administrating
8. Placing LASA medications in locations separate from each other in non
alphabetical order

Correct-site, correct-procedure,
correct-patient Surgery IPSG4

Correct-site, correct-procedure, correct-
patient Surgery IPSG4
Definitions of:
• Time out
• Pre-op/ pre procedure
verification

Correct-site, correct-procedure, correct-
patient Surgery IPSG4 Policy
Surgical site marking
Surgical safety checklist
Timeout

international patient safety goals 3-4

international patient safety goals 3-4

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