Professional Documents
Culture Documents
(HAMs)
Education for Staff
May 2015
High Alert Medications (HAMs)
Learning Objectives:
Define and identify what High Alert
Medications (HAMs) are.
Be aware and understand the risks, errors
and adverse events associated with HAMs.
Be familiar with the key messages in the
policies and procedures and the educational
resources on CompassionNet
Be familiar with HAM safeguards
Education for HAMs
1) IV Adrenergic agonists
(e.g. epinephrine, ephedrine, dopamine, dobutamine, etc.)
2) Anesthetic agents
4) Chemotheraphy medications
HAM Categories (con’t)
The following HAM categories have been associated with errors within the
Organization as well as globally ( AHS, etc):
6) Insulin
7) Liposomal Drugs
8) Narcotics
HAM audits
• HAM audits are to be done annually.
• Audit tools are provided by the Medication Management
Safety Team
Risk Reduction Strategies
Standardizing storage and labelling of
mediations
• Poor storage and unclear labelling of medications can lead to
selection errors
VS
Auxiliary
Labels
Pyxis Storage
HAM
HAM Auxiliary label: ICON
ICON Concentrated Electrolytes
Additional Risk Reduction Strategies
Patient Monitoring Access effects of meds through Vital sign, lab tests,
constant feed-back loop. neurological signs for patients
having HAM
Monitor for effects of HAM
Chart Audits (e.g. insulin
induced hypoglycemia,
heparin/warfarin induced
bleeding, use of narcan for over
sedation.
Improve access to information Active means of providing staff Current drug database
and patients with necessary Quick reference tables
information exactly when Increased visibility pharmacists
required, during critical tasks Medical librarian
Computer order entry
1.Access
Policies and
Procedures
2.Medication
Management
High Alert
Medication
Institute Of Medicine’s (IOM)
Quality Chasm Series
HAM Policy Suite: Contents & Links
Covenant Health High Alert Medications
http://www.compassionnet.ca/Policies/VII-A-30.pdf
Covenant Health Managing of High Alert Medications:
High Potency Narcotics Policy
http://www.compassionnet.ca/Policies/VII-A-40.pdf
Covenant Health Managing of High Alert Medications:
Heparin Policy
http://www.compassionnet.ca/Policies/VII-A-35(1).pd
f
Covenant Health Managing of High Alert Medications:
Concentrated Electrolyte Policy
http://www.compassionnet.ca/Policies/VII-A-10(1).pd
f
References
1. Alberta Health Services High Alert Medication Policy Education power point Retrieved November 4, 2014, from
http://insite.albertahealthservices.ca/10449.asp
2. Choo,J., Hutchinson,A.,& Bucknall,T.(2010) Nurses’ role in medication safety. Journal of Nursing Management,18,853-861
3. Cuirong,X., Guohong,L., Nanyuan,Y., & Yanyan,l.(2012). An intervention to improve medication management : A before and
after study. Journal of Nursing Management, 22,286-294.
4. Disclosure of Adverse Events, Close Calls &Hazards Policy No. III-40 Retrieved November 6 , 2014 from
http://www.compassionnet.ca/Policies/iii-40.pdf
5. High Alert Medication Policy VII-A-30 Retrieved November 7,2014 from http://www.compassionnet.ca/Policies/VII-A-
30.pdf
9. Institute for Safe Medication Practices Canada, Home Page Retrieved November 9, from
http://www.ismp-canada.org/index.htm
10. ISMP Canada Safety Bulletin Volume 14 Issue 4 April 16 2014 Alert: Wrong Route Incidents with Epinephrine Retrieved
November 1 2014 http://www.ismp-canada.org/download/safetyBulletins/2014/ISMPCSB2014-4_Epinephrine.pd
2. Pennsylvania Patient Safety Advisory PA PSRS Patient Saf Advis (2006 Dec;3) Let’s Stop the Bleeding: Preventing
Errors with Heparin Therapy Retrieved November 1, 2014, http://patientsafetyauthority.org/ADVISORIES/AdvisoryLi
3. Presentation Summary : QSEN (Quality and Safety Education in Nursing) Partnership in Education and Practice
Jane H. Barnsteiner, PhD, RN, FAAN Professor, University of Pennsylvania Retrieved November ,24,2014 from
http://www.qsen.org/wp-content/uploads/2012/11/EmoryJowers.07.ppt
5. Responding to Adverse Events, Close Calls and Hazards Policy No. III-45 Retrieved November,7,2014 from
http://www.compassionnet.ca/Policies/iii-45.pdf
6. Ross Baker, G., Norton,P.G., Flintoft,V., Blais,R., Brown.A., Cox.J., et al.(2004).The Canadian Adverse Events Study:
incidence of adverse events among hospital patients in Canada.Canadian Medical Association Journal/170,1678-
1686
7. Smetzer, Judy BSN,FISMP Medication Safety Intensive Conference –Culture of Patient Safety: Embracing a Just Culture
Institute for Safe Medication Practices Retrieved Dec 16, 2014
8. Western Australian Department of Health Medication Safety Retrieved November 12,2014 from
http://www.safetyandquality.health.wa.gov.au/medication/index.cfm
9. World Health Organization. Improving Medication Safety. WHO Patient Safety Curriculum Guide: Multiprofessional
Edition, 2011. Retrieved November 12,2014 from http://www.who.int/patientsafety/education/curriculum/en/index.html