title: High-alert medications in a French paediatric university hospital.
abstract: OBJECTIVE
  High-alert medications (HAMs) are medications that are associated with a high risk of serious harm if used improperly. The objective of this study was to identify paediatric HAM used in our institution and to identify safety measures for their use.
  
  
  METHODS
  The list of HAM and the list of safety measures that were introduced in our department were based on (1) a literature search; (2) a survey of health care professionals in our department including doctors, head nurses, nurses and pharmacists; and (3) the drug steering committee.
  
  
  RESULTS
  We found four lists of HAM based on a literature search, including 27 classes of pharmaceutical agents, and 63 common drug names. The response rate of the survey was 20.7% (230 of 1113). Some of the HAMs included in our list were not identified by the literature search. These included neuroleptic drugs, anti-malarial agents, antiviral agents, anti-retroviral agents and intravenous acetaminophen. The drug steering committee selected 17 HAM and highlighted 53 safety measures involving seven broad aspects of pharmacological management.
  
  
  CONCLUSIONS
  This project was part of the new safety strategies developed in a paediatric hospital. We set out to make a list of HAM relevant to paediatrics with additional safety measures to prevent medication errors associated and a 'joker' system. The various safety measures, such as double-checking of HAM prescriptions, should be reviewed during the year following their implementation. This list, which was developed in our hospital specifically for use in paediatrics, can be adapted for use in other paediatric departments.
authors.affiliation: Hôpital Robert-Debré, APHP, Pharmacie Clinique, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Bataille
authors.forename: Sonia
authors.initials: S
authors.lastname: Prot-Labarthe
authors.forename: Olivier
authors.initials: O
authors.lastname: Bourdon
authors.forename: Perrine
authors.initials: P
authors.lastname: Joret
authors.forename: Françoise
authors.initials: F
authors.lastname: Brion
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Hartmann
mesh_terms: D005602:France; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety; D010564:Personnel, Hospital; D055553:Prescription Drugs / Q000145:classification*; D018570:Risk Assessment
chemical_list: D055553:Prescription Drugs
keywords: clinical safety; high-alert medication; medication errors; paediatrics; prevention; quality of health care