High risk medicines: Quality Use of Medicines - Victorian Government Health Information, Australia

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High risk medicines

Page contents: High risk medicine alert system | Publications and links | Guidelines

High Risk Medicines (HRM) can be defined as a those which have a heightened risk of causing significant or catastrophic harm when used in error.

This includes:

medicines with a low therapeutic index
medicines that present a high risk when administered via the wrong route or when other systems errors occur.

The VMAC HRM working party are focusing on the development of initiatives for the following drugs and categories:

P - potassium
I - insulin
N - narcotics
C - chemotherapy
H - heparin
S - systems

High risk medicine alert system

The aim of this alert system is to:

warn healthcare professionals about serious known medication risks
outline the action required to minimise risks
provide tools to facilitate risk minimisation.

Note: Audit tools are provided to assist organisations in evaluating local practice. The Department of Human Services does not require data to be submitted.

High Risk Medicine	Alert and location
Potassium	Potassium – Australian Commission on Safety and Quality in Healthcare (ACSQHC), South Australia (SA), Victoria (VIC), Western Australia (WA), UK
Insulin	Subcutaneous insulin Subcutaneous Insulin - Alert (51kb, pdf) Subcutaneous Insulin - Audit tool (338kb, word)
Narcotics	Fentanyl patch notice, Victoria (VIC) (48kb, pdf) Fentanyl patches – New South Wales (NSW) National Patient Safety Agency (NPSA) alerts National Health Service (NHS) to risks with high dose morphine and diamorphine injections Oxycodone alert regarding the range, strength and variable rates of release of oxycodone products available - New South Wales (NSW) Pethidine in emergency departments: promoting evidence based prescribing (246kb, pdf) Available from the The Medical Journal of Australia website.
Chemotherapy	Oral chemotherapy for cancer notice - Information for community health professionals(66kb, pdf) Oral chemotherapy for cancer audit tool for health services (279kb, MS Word) Oral chemotherapy for cancer notice - Information for health services (70kb, pdf) Methotrexate - UK
Heparin (and other anticoagulants)	Enoxaparin – Queensland (QLD) Medication Safety Self Assessment for antithrombotic therapy Warfarin - NSW Actions that can make anticoagulant therapy safer - UK Unfractionated Heparin – Alert (89kb, pdf) Unfractionated Heparin – Audit Tool (79kb, pdf) Unfractionated Heparin - Audit Tool (363kb, MS Word)
Systems	Clinical Handover - Victorian Quality Council Promoting safer measurement and administration of liquid medicines via oral and other enteral routes - UK NSW TAG recommendations for terminology, abbreviations and symbols used in the prescribing and administration of medicines (283kb, pdf) Wrong route administration of oral liquid medicines Wrong Route Administration of Oral Liquid Medicines - Alert (as at July 2008) (61kb, pdf) Wrong route administration of oral liquid medicines - Audit tool (as at July 2008) (387kb, MS Word)

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Provide us with your feedback!

The high risk medicines safety information survey has been designed to capture feedback from healthcare professionals to help us tailor future safety information to meet local needs. Feedback is confidential.

Visit the the survey here

Publications and links

Vincristine can be fatal if administered by the intrathecal route. How does your organisation measure up against the vincristine alert recommendations? Download the attached file to audit your practice.

High risk medicine alert audit - vincristine (178kb, pdf)

Confusing drug names is one of the most common causes of medication error. The attached article provides details of the issues and some suggestions to minimise the risks.

Look-alike, sound-alike medication names (659kb, pdf)

Alerts and Advisories links:

Guidelines

Victorian guideline for the replacement of potassium.

This guideline has been produced by VicTAG.

Intravenous administration of potassium chloride (72kb, pdf)

Guidelines for the use of oral methotrexate in hospitals.

Prepared by the Victorian Medication Safety Committee (VMSC).

Guidelines for the use of oral methotrexate in hospitals (42kb, pdf)

High risk medicines working party

High risk medicines working party members (27kb, pdf)

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Last updated: 30 November, 2010
This web site is managed and authorised by the Quality, Safety & Patient Experience Branch, Hospital & Health Service Performance Division of the Victorian State Government, Department of Health, Australia

For general enquiries to the Department of Health telephone 61 3 90960000