Strategies
Purchasing for Safety
Pharmacy teams can help to mitigate risks through their purchasing strategy. Avoid purchase of high-risk products if possible but be aware that lack of market choice is making it increasingly difficult to do this. See Purchasing for safety (SPS page)
Use ready-to-administer products where possible
When licensed ready-to-administer products are unavailable, make available unlicensed ready-to-administer or ready-to-use injectable products where possible.
When the risk assessment tool has identified that risk reduction measures are required, consideration should be given to mitigation measures. Examples are provided below.
Examples of other risk mitigation measures
This list is not exhaustive.
Simplify and rationalise stock
Simplify and rationalise as far as possible the range of products and presentations of injectable medicines stocked in clinical areas and keep only the most appropriate vial/ampoule sizes.
Maintain awareness of look-alike and sound-alike errors
Be aware that some clinicians believe that ready-to-use preparations increase the risk of look-alike errors.
Provide aids such as dose calculators
To minimise the need for dose calculations, consider providing aids such as a dosage chart for a range of body weights.
Provide additional written guidance
Provide additional written guidance such, as clinical area worksheets, on how to prescribe, prepare and administer high-risk injectable medicines
Provide locally-approved protocols
Provide locally approved protocols that detail when unlicensed and ‘off-label’ use of injectable medicines is supported by local medicines policy
Encourage use of infusion monitoring forms
Encourage use of an infusion monitoring form to help ensure that infusions are monitored throughout administration
Consider the value of in-process checks
Consider introducing systems such as independent second checks of key steps in preparation by another experienced practitioner.
Consider use of “Smart” infusion devices
These devices can be set up and validated to only allow administration within approved parameters and therefore, if used properly by staff trained in their use, can provide a hard barrier which will minimize the likelihood of errors.