New ISMP Best Practices Underscore Facility-Wide Consistency

Institute for Safe Medication Practices revises two of its six existing best practices, adds five more

The Institute for Safe Medication Practices’ (ISMP) recently released “2016-2017 Targeted Medication Safety Best Practices for Hospitals,” which includes revisions to two existing best practices and five additional recommendations to reduce common medication errors.

All told, the ISMP recommendations target 11 areas in which medication errors “continue to cause fatal and harmful errors in patients, despite repeated warnings in ISMP publications,” according to the guidelines. ISMP recommends hospitals focus on the first six recommendations, all of which are repeats from the 2014?2015 guidelines, before addressing the organization’s new best practices.

Two key revisions of the 2014-2015 best practices include:

• Alternatives to a hard stop for oral methotrexate: Previous guidelines required hard stop verification of an appropriate oncologic indication for all daily oral methotrexate orders. That recommendation is still in effect, but according to Darryl S. Rich, PharmD, MBA, FASHP, a medication safety specialist with ISMP in Horsham, Pennsylvania, hospitals were having difficulty programming computer systems to initiate the hard stop. In this year’s update, ISMP included two clarifications, indicating that for manual systems and electronic order entry systems that don’t have the capability to perform a hard stop, clinicians must clarify all daily orders for methotrexate for patients with no documented oncologic diagnosis. Additionally, hospitals need to work with vendors and IT departments to ensure a hard stop feature is made available.

This is an excerpt from the June issue of the Patient Safety Monitor. Subscribers can read the rest of the article here. Find out more about the journal, its benefits, and how to subscribe by clicking here.