title: Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital.
abstract: BACKGROUND
  High-alert medications pose a greater risk of causing significant harm to patients if used in error. The Joint Commission requires that hospitals define institution-specific high-alert medications and implement processes to ensure safe medication use.
  
  
  METHODS
  Nursing, pharmacy, and prescribers were asked to voluntarily complete a 34-question survey to assess their knowledge, experience, and perceptions regarding high-alert medications in an academic hospital.
  
  
  RESULTS
  The majority of respondents identified the organization's high-alert medications, the consequences of an error involving a high-alert medication, and the reversal agent. Most of the risk-reduction strategies within the institution were viewed as being effective by respondents. Forty-five percent of the respondents utilized a high-alert medication in the previous 24 hours. Only 14.2% had experienced an error with a high-alert medication in the previous 12 months, with 46% being near misses. The survey found the 5 rights for medication administration were not being utilized consistently. Respondents indicated that work experience or hospital orientation is the preferred learning experience for high-alert medications.
  
  
  CONCLUSIONS
  This study assessed all disciplines involved in the medication use process. Perceptions about high-alert medications differ between disciplines. Ongoing discipline-specific education is required to ensure that individuals accept accountability in the medication use process and to close knowledge gaps on high-alert medications and risk-reduction strategies.
authors.affiliation: University of Michigan Health System , Ann Arbor, Michigan ; University of Michigan College of Pharmacy , Ann Arbor, Michigan.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Engels
authors.affiliation: University of Michigan Health System , Ann Arbor, Michigan ; University of Michigan College of Pharmacy , Ann Arbor, Michigan.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Ciarkowski
keywords: high-alert medications; nursing; pharmacy; prescribers