Introduction to High Risk Medicines
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What you will learn
This module is the first in a series to promote the safety of high risk medicines in different healthcare settings.
It describes general information about high risk medicines, errors with high risk medicines, and strategies for safe management of high risk medicines.
Safety information about each of the high risk medicine groups is covered in other modules in the series.
Learning outcomes
On completion of this module you will be able to:
- identify what makes a medicine ‘high risk’
- identify high risk medicines
- explain how medication errors occur
- explain strategies to improve management of high risk medicines
- describe resources/tools available to help in the safe management of high risk medicines.
About this module
Target Audience
This module is intended for all healthcare staff involved in the management of high risk medicines.
Duration
The module is designed to take around half an hour to complete.
Certificate
On successful completion of the assessments you can download a certificate of completion.
Compliance
This module aligns with the National Safety and Quality Health Service Standards, Second Edition – Standards 1, 2, 4 & 6.
Disclaimer
This module content was developed by the Australian Commission on Safety and Quality in Health Care and is protected by copyright under a Creative Commons Attribution-Non-Commercial-Share Alike (BY-NC-ND) 4.0 International License.
The content is provided in good faith by the Commission for information purposes. It is not a substitute for, and is not intended to replace, any specific policies, guidelines or requirements for your local health network or health service.
The Commission does not accept any legal liability or responsibility for any injury, loss or damage incurred by the use of, or reliance on, this information.
Course release dates
| Date | |
|---|---|
| May 2024 | Updated to include new case studies and changes to current practice, policies and standards. |
| November 2023 | Under review. |
| October 2023 | Updated to include new APINCHS and variations of APINCHS used in differrent states. |
| October 2014 | First released. |
Resources
General resources
- The National Safety and Quality Health Service (NSQHS) Standards. Australian Commission on Safety and Quality in Health Care (ACSQHC).
- National Standard Medication Charts. ACSQHC.
- High Risk Medicines. ACSQHC.
- ISMP List of High-Alert Medications in Acute Care Settings. ISMP 2014. Institute for Safe Medication Practices.
APINCHS List
- APINCHS classification of high risk medicines. ACSQHC.
- High Risk Medicines. New South Wales Government. Clinical Excellence Commission.
- High Risk Medications. Government of Western Australia. Department of Health.
- High Risk Medicines.Government of South Australia. Department of Health.
Medication errors
- What is the problem? Australian Government, Therapeutic Goods Administration.
- Medicine Safety: Take Care. Canberra. PSA. 2019. Pharmaceutical Society of Australia.
- National baseline report on Quality Use of Medicines and Medicines Safety – Phase 1: Residential aged care. Sydney. 2021. ACSQHC.
- Transitions of Care. ACSQHC.
- Reason J. Human error: models and management. BMJ. 2000 Mar 18;320(7237):768-70. doi: 10.1136/bmj.320.7237.768. PMID: 10720363; PMCID: PMC1117770.
Just culture
- Just culture training and resources. 2022. Safer Care Victoria.
- Patient Safety – Just Culture. 2022. Government of Western Australia Department of Health.
Risk reduction strategies
- Recommendations for terminology, abbreviations and symbols used in medicines documentation. ACSQHC.
- National Safety and Quality Health Service Standards – Medication Safety. ACSQHC.
- Principles for the safe selection and storage of medicines – Guidance on the principles and survey tool. Sydney. 2020. ACSQHC.
- National Tall Man Lettering List. Sydney: 2020. ACSQHC.
- National Standard for User-applied Labelling of Injectable Medicines Fluids and Lines. (2015). ACSQHC.
- Hierarchy of Controls. Quality Systems Toolbox.
- Education is “predictably disappointing” and should never be relied upon alone to improve safety. Institute of Safe Medication Practice.
- National Safety and Quality Health Service Standards – Partnering with Consumers. ACSQHC.
Opioids
- Principles for the safe selection and storage of medicines. 2020. ACSQHC.
- Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard – Acute care edition. 2022. ACSQHC.
Oral methotrexate
- Fact sheet-Medicine Management in the Community. 2022. Australian Government. Department of Health and Aged Care.
- Position Statement on the use of low-dose methotrexate. CATAG, 2020. Council of Australian Therapeutic Advisory Groups.
- Safe use of low-dose methotrexate factsheet. CATAG, 2020. Council of Australian Therapeutic Advisory Groups.
Alteration of oral dosage forms
- Guiding Principles for Medication Management in the Community. 2022. ISBN: 978-1-76007-472. Australian Government. Department of Health and Aged Care.
- Don’t Rush to Crush. Society of Hospital Pharmacists of Australia (SHPA). Also available online through eMIMS, MIMS Online and AusDI.
- Altering dosage forms for older adults. Australian Prescriber 2018;41:191-3. Taylor S, Glass B.
- How to prepare your medicine if you have difficulty swallowing. Society of Hospital Pharmacists of Australia (SHPA).
Time critical medicines
- Medicines Information Q&A. Vol 2 (1). 2020. Society of Hospital Pharmacists of Australia.
- Guiding Principles for Timely Administration of Medicines. 2020. Western Australia Department of Health.
- Time sensitive medicines 2023. Care Quality Commission.
- Guidelines for Timely Administration of Scheduled Medicines (Acute). 2011. Institute of Safe Medicine Practice.
Oral liquid medicine
- Preventing Paediatric Medication Errors. 2015. New Zealand Medicines and Medical Devices Safety Authority (MEDSAFE).
- Quality Use of Medicines Safety Alert: Wrong route administration of oral liquid medicines. Vol 1 (1). February 2008. Victorian Medicines Advisory Committee (VMAC).
- Oral liquids and oral syringes. Government of Western Australia. Department of Health.
- How to give medicines to children (video) NPS Medicinewise.
- ISMP Medicine Safety Alert – Community/Ambulatory Care. Prescribing and dispensing errors with oral solutions. Vol 15 (5). May 2016. Institute of Safe Medicine Practice.
- Smith L, Leggett C, Borg C. Administration of medicines to children: a practical guide. Australian Prescriber 2022;45:188-92.
Acknowledgements
Content team
- Lisa Pont PhD, Professor of Pharmacy, University of Technology Sydney (UTS)
- Bonnie Tai, B Pharm (Hons), M Clin Pharm, Adv Pract Pharm, MSHP
Contributors to the previous version of this course
Medicines and Technology Policy and Programs Branch (MTPP), SA Health:
- Naomi Burgess, Director
- Anita Abarno, Senior Pharmacist, Medication Safety
- Kaye Barratt, Senior Specialist Pharmacist
SA Health would also like to acknowledge and thank the following:
- Carolyn Field, Women’s and Children’s Health Network
- Kirsty Scarborough, Central Adelaide Local Health Network
- Kerrie Westaway, Medical Writer, Sansom Institute, University of South Australia (previously Senior Project Officer, Medication Safety, MTPP, SA Health)
- Women’s and Children’s Hospital Pharmacy Department
