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KMID : 0869620220390040498
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Journal of Korean Society of Hospital Pharmacists
2022 Volume.39 No. 4 p.498 ~ p.507
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Developing National Level High Alert Medication Lists for Long-Term Care Patients
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Lee Su-Hyun
Han Ji-Min
Heo Kyu-Nam
Lee Ah-Young
Min Sang-Il
Kim A-Jeong
Kim Sung-Hwan
Jo Yun-Hee
Cho Yoon-Sook
Ah Young-Mi
Lee Ju-Yeun
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Abstract
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Background : High-alert medications (HAMs), the prominent cause of medication harm, can have serious consequences for patients. They should be developed and managed according to institutions. However, HAMs for long-term care (LTC) hospitals presented in hospital accreditation standards in Korea are based on the list of HAMs of acute care hospitals. The aim of this study was to develop a national-level list of high-alert medications for LTC hospitals.
Methods : A combined strategy of literature review, epidemiological data analysis of medication error-related incidents, medication utilization, and a survey of expert opinions was applied. We identified candidates of HAMs for LTC from the Institute for Safe Medication Practices (ISMP) and the list of Korean hospital accreditation standards. We analyzed the following database to identify medication error and utilization: the Korea Patients Safety Reporting & Learning System (KOPS) and Korea Adverse Event Reporting System (KAERS), and sample data from national claims. Seven experts working in LTC hospitals evaluated the adequacy and priority of candidate medications.
Results : We derived a final list of 16 high-alert medications, including six essential medications (insulin vials, heparin and low molecular weight heparins, hypertonic sodium chloride solutions, concentrated potassium injections, concentrated magnesium injections, and oral chemotherapeutic agents) and 10 optional medications (insulin pens, oral anticoagulants, immunosuppressants, parenteral nutrients for central veins, parenteral chemotherapeutic agents, parenteral benzodiazepines, contrast agents, phenytoin, epinephrine injections, and oral digoxin).
Conclusion : We developed a list of high-alert medications for LTC settings at the national level, which may improve medication use and safety in patients who receive LTC.
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KEYWORD
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High-alert medication, Long-term care hospita, Medication safety
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