title: Safe medication use based on knowledge of information about contraindications concerning cross allergy and comprehensive clinical intervention.
abstract: BACKGROUND
  An investigation of safety issues regarding information on contraindications related to cross allergy was conducted to promote clinical awareness and prevent medical errors in a 2200-bed tertiary care teaching hospital.
  
  
  METHODS
  Prescribing information on contraindications concerning cross allergy was collected from an information system and package inserts. Data mining and descriptive analysis were performed. A risk register was used for project management and risk assessment. A Plan, Do, Check, Act cycle was used as part of continuous quality improvement. Records of drug counseling and medical errors were collected from an online reporting system. A pharmacist-led multidisciplinary team initiated an intervention program on cross allergy in August 2008.
  
  
  RESULTS
  Four years of risk management at our hospital achieved successful outcomes, ie, the number of medical errors related to cross allergies decreased by 97% (10 cases monthly before August 2008 versus three cases yearly in 2012) and risk rating decreased significantly [initial risk rating: 25(high-risk) before August 2008 versus final risk rating:6 (medium-risk) in December 2012].
  
  
  CONCLUSIONS
  We conclude that comprehensive clinical interventions are very effective through team cooperation. Medication use has potential for safety risks if sufficient attention is not paid to contraindications concerning cross allergy. The potential for cross allergy involving drugs which belong to completely different pharmacological classes is easily overlooked and can be dangerous. Pharmacists can play an important role in reducing the risk of cross allergy as well as recommending therapeutic alternatives.
authors: Division of Medical Affairs, , School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors: Wei
authors: W
authors: Li
authors: Ling-Ling
authors: LL
authors: Zhu
authors: Quan
authors: Q
authors: Zhou
keywords: clinical pharmacy; contraindications; cross allergy; prescribing information; risk management; safe medication use