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Standardization of labeling:
IV infusions must include required alerts,
warnings and labels
Standardized doses and concentrations
Recommendations for use of Smart pump
technology if given as an IV infusion
Time Out for vinca alkaloids and all
medications administered by the intrathecal
route
Question:
The High Alert Medication Policy includes:
A. Independent double check at bedside
B. High alert medication list
C. Standardized concentration
D. Recommendations for use of Smart
pump technology for IV infusions.
E. All of the above
Answer:
E - All of the above. More options
include:
Time out for vinca alkaloids
Documentation in the electronic
medical record at time of
administration.
Question:
During the independent double check, if two
health practitioners do not agree on the
calculated dose, they should take the
average between their two numbers.
True or False?
Answer:
False
A pharmacist should be consulted in the
event that agreement cannot be reached.
http://kpnet.kp.org/nursing/national/learning/c
el/highalertmed/index.html
Question:
Name 3 steps that must be completed
(as appropriate), along with the 5
rights, during an independent double
check?
1) Vinca alkaloids
2) All medications administered by the
intrathecal route and must be conducted
immediately before starting administration/
procedure, in the location where the
procedure will be done.
Question:
The high alert medication Time Out involves
the entire care/procedure team except the
physician?
True or False?
Answer:
False!
It includes the physician and the patient. The
team also must use active communication
which is documented using KP Universal
Protocol documentation systems.
All High Alert Meds Require an independent double check at the bedside by
& Routes two appropriate persons and documentation on medical
record at administration, at bag change and at
transfers/handoffs.
In addition, the process of performing an independent
double check includes checking labeling, IV tubing
connection and site of line insertion along with other
factors as appropriate.
Includes all inpatient and outpatient settings
All physicians, nurses and others who administer
medications will have medication administration training
and will comply with the regional policy and procedure
Red High Alert stickers are utilized
Emergency situations (i.e., Codes) are excluded
A current admission weight should be obtained for all
patients and fluctuations in body weight assessed when
needed to ensure accurate weight-based dosing
calculation.
All Intrathecal meds Requires staff follow the Universal Protocol for Time Out
Vinca Alkaloids Dispensed in mini-bag, rare exception for peds with non-
VinCRIStine central line
VinBLAStine
Vinorelbine
Requires a Time Out
Labeled Fatal if given intrathecally. For IV use only. Do
not remove covering until moment of injection.
Neuromuscular Restrict floor stock to ED, OR, PACU, Critical Care and LDRP
Blocking Agents Store separately with special labeling to differentiate from other
meds
Use identification techniques (e.g., labels, etc) shrink wrap not
required
Verify intubation status prior to administration
Clinical Data Category alert in PYXIS
Question:
Who will prepare U500 insulin for
subcutaneous administration and what type
of syringe will be used?
Answer:
Pharmacy will prepare all U500 insulin
doses in 1 ml TB syringes with patient
specific labeling for nurses to administer.
True or False?