Results for ISMP Survey on High-Alert Medications

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Total: 369

Medication or Class of Medications

Unless otherwise stated, the intended use for all medications is pediatric and adult patients.

Section A

Do YOU believe this is a high-alert medication?

Section B

Does YOUR PRACTICE SITE consider this a high-alert medication with special precautions in place?

Class/Category of Medications Yes No Yes No
1. IV adrenergic agonists (e.g., epinephrine) 69% 31% 47% 53%
2. IV adrenergic antagonists (e.g., propranolol) 51% 49% 32% 68%
3. Parenteral chemotherapeutic agents 98% 2% 90% 10%
4. Oral chemotherapeutic agents 73% 27% 60% 40%
5. Neuromuscular blocking agents (e.g., succinylcholine) 94% 6% 78% 22%
6. IV thrombolytics/fibrinolytics (e.g., tenecteplase) 82% 18% 63% 37%
7. Liposomal forms of drugs (e.g., amphotericin B) 45% 55% 23% 77%
8. Glycoprotein IIb/IIIa inhibitors (e.g., tirofiban) 63% 37% 44% 56%
9. IV conscious sedation agents (e.g., midazolam) 75% 25% 64% 36%
10. Oral conscious sedation agents for children (e.g., chloral hydrate) 68% 32% 46% 54%
11. Oral/IM narcotics/opiates 52% 48% 40% 60%
12. IV narcotics/opiates 74% 26% 61% 39%
13. Dialysate 34% 66% 22% 78%
14. Cardioplegic solutions 62% 38% 42% 58%
15. Total parenteral nutrition 57% 43% 53% 47%
16. Inhaled and IV general anesthetic agents (e.g., propofol) 77% 23% 58% 42%
17. IV inotropic medications (e.g., digoxin, milrinone) 67% 33% 45% 55%
18. Benzodiazepines in patients over 65 (e.g., alprazolam) 47% 53% 29% 71%
19. Oral hypoglycemic agents (e.g., glipizide) 23% 77% 14% 86%
20. Low molecular weight heparin 50% 50% 37% 63%
Specific Medications Yes No Yes No
22. Warfarin 73% 27% 53% 47%
23. IV heparin 87% 13% 80% 20%
24. Subcutaneous insulin 71% 29% 60% 40%
25. IV insulin 90% 10% 78% 22%
26. IV magnesium sulfate 70% 30% 58% 42%
27. IV calcium gluconate 61% 39% 50% 50%
28. IV calcium chloride 66% 34% 52% 48%
29. IV potassium phosphate 90% 10% 79% 21%
30. IV potassium chloride 96% 4% 90% 10%
31. Hypertonic sodium chloride injection 91% 9% 75% 25%
32. High concentration dextrose injection 58% 42% 44% 56%
33. IV theophylline 50% 50% 35% 65%


Total for Nurse: 60

Medication or Class of Medications

Unless otherwise stated, the intended use for all medications is pediatric and adult patients.

Section A

Do YOU believe this is a high-alert medication?

Section B

Does YOUR PRACTICE SITE consider this a high-alert medication with special precautions in place?

Class/Category of Medications Yes No Yes No
1. IV adrenergic agonists (e.g., epinephrine) 92% 8% 62% 38%
2. IV adrenergic antagonists (e.g., propranolol) 81% 19% 56% 44%
3. Parenteral chemotherapeutic agents 96% 4% 82% 18%
4. Oral chemotherapeutic agents 72% 28% 63% 37%
5. Neuromuscular blocking agents (e.g., succinylcholine) 91% 9% 65% 35%
6. IV thrombolytics/fibrinolytics (e.g., tenecteplase) 87% 13% 71% 29%
7. Liposomal forms of drugs (e.g., amphotericin B) 68% 32% 46% 54%
8. Glycoprotein IIb/IIIa inhibitors (e.g., tirofiban) 76% 24% 53% 47%
9. IV conscious sedation agents (e.g., midazolam) 86% 14% 78% 22%
10. Oral conscious sedation agents for children (e.g., chloral hydrate) 84% 16% 68% 32%
11. Oral/IM narcotics/opiates 69% 31% 64% 36%
12. IV narcotics/opiates 83% 17% 71% 29%
13. Dialysate 66% 34% 63% 37%
14. Cardioplegic solutions 86% 14% 74% 26%
15. Total parenteral nutrition 65% 35% 65% 35%
16. Inhaled and IV general anesthetic agents (e.g., propofol) 88% 13% 70% 30%
17. IV inotropic medications (e.g., digoxin, milrinone) 77% 23% 67% 33%
18. Benzodiazepines in patients over 65 (e.g., alprazolam) 71% 29% 54% 46%
19. Oral hypoglycemic agents (e.g., glipizide) 31% 69% 38% 62%
20. Low molecular weight heparin 47% 53% 38% 62%
Specific Medications Yes No Yes No
22. Warfarin 59% 41% 49% 51%
23. IV heparin 81% 19% 78% 22%
24. Subcutaneous insulin 63% 37% 58% 42%
25. IV insulin 91% 9% 82% 18%
26. IV magnesium sulfate 77% 23% 63% 38%
27. IV calcium gluconate 79% 21% 62% 38%
28. IV calcium chloride 79% 21% 60% 40%
29. IV potassium phosphate 88% 12% 73% 27%
30. IV potassium chloride 91% 9% 76% 24%
31. Hypertonic sodium chloride injection 73% 27% 56% 44%
32. High concentration dextrose injection 63% 37% 53% 47%
33. IV theophylline 66% 34% 53% 47%


Total for Pharmacist: 232

Medication or Class of Medications

Unless otherwise stated, the intended use for all medications is pediatric and adult patients.

Section A

Do YOU believe this is a high-alert medication?

Section B

Does YOUR PRACTICE SITE consider this a high-alert medication with special precautions in place?

Class/Category of Medications Yes No Yes No
1. IV adrenergic agonists (e.g., epinephrine) 63% 37% 40% 60%
2. IV adrenergic antagonists (e.g., propranolol) 43% 57% 26% 74%
3. Parenteral chemotherapeutic agents 100% 0% 93% 7%
4. Oral chemotherapeutic agents 71% 29% 56% 44%
5. Neuromuscular blocking agents (e.g., succinylcholine) 95% 5% 81% 19%
6. IV thrombolytics/fibrinolytics (e.g., tenecteplase) 82% 18% 62% 38%
7. Liposomal forms of drugs (e.g., amphotericin B) 39% 61% 18% 82%
8. Glycoprotein IIb/IIIa inhibitors (e.g., tirofiban) 63% 37% 43% 57%
9. IV conscious sedation agents (e.g., midazolam) 73% 27% 61% 39%
10. Oral conscious sedation agents for children (e.g., chloral hydrate) 66% 34% 40% 60%
11. Oral/IM narcotics/opiates 46% 54% 30% 70%
12. IV narcotics/opiates 70% 30% 55% 45%
13. Dialysate 26% 74% 12% 88%
14. Cardioplegic solutions 58% 42% 35% 65%
15. Total parenteral nutrition 58% 42% 52% 48%
16. Inhaled and IV general anesthetic agents (e.g., propofol) 75% 25% 56% 44%
17. IV inotropic medications (e.g., digoxin, milrinone) 64% 36% 40% 60%
18. Benzodiazepines in patients over 65 (e.g., alprazolam) 40% 60% 22% 78%
19. Oral hypoglycemic agents (e.g., glipizide) 21% 79% 7% 93%
20. Low molecular weight heparin 48% 52% 32% 68%
Specific Medications Yes No Yes No
22. Warfarin 75% 25% 52% 48%
23. IV heparin 89% 11% 82% 18%
24. Subcutaneous insulin 72% 28% 59% 41%
25. IV insulin 90% 10% 78% 22%
26. IV magnesium sulfate 68% 32% 57% 43%
27. IV calcium gluconate 56% 44% 46% 54%
28. IV calcium chloride 63% 37% 50% 50%
29. IV potassium phosphate 90% 10% 82% 18%
30. IV potassium chloride 98% 2% 95% 5%
31. Hypertonic sodium chloride injection 94% 6% 80% 20%
32. High concentration dextrose injection 56% 44% 42% 58%
33. IV theophylline 46% 54% 28% 72%


Total for Other: 77

Medication or Class of Medications

Unless otherwise stated, the intended use for all medications is pediatric and adult patients.

Section A

Do YOU believe this is a high-alert medication?

Section B

Does YOUR PRACTICE SITE consider this a high-alert medication with special precautions in place?

Class/Category of Medications Yes No Yes No
1. IV adrenergic agonists (e.g., epinephrine) 71% 29% 57% 43%
2. IV adrenergic antagonists (e.g., propranolol) 50% 50% 31% 69%
3. Parenteral chemotherapeutic agents 94% 6% 88% 12%
4. Oral chemotherapeutic agents 82% 18% 68% 32%
5. Neuromuscular blocking agents (e.g., succinylcholine) 91% 9% 76% 24%
6. IV thrombolytics/fibrinolytics (e.g., tenecteplase) 77% 23% 61% 39%
7. Liposomal forms of drugs (e.g., amphotericin B) 48% 52% 25% 75%
8. Glycoprotein IIb/IIIa inhibitors (e.g., tirofiban) 52% 48% 39% 61%
9. IV conscious sedation agents (e.g., midazolam) 72% 28% 66% 34%
10. Oral conscious sedation agents for children (e.g., chloral hydrate) 62% 38% 52% 48%
11. Oral/IM narcotics/opiates 57% 43% 55% 45%
12. IV narcotics/opiates 79% 21% 70% 30%
13. Dialysate 34% 66% 23% 77%
14. Cardioplegic solutions 56% 44% 40% 60%
15. Total parenteral nutrition 47% 53% 47% 53%
16. Inhaled and IV general anesthetic agents (e.g., propofol) 75% 25% 58% 42%
17. IV inotropic medications (e.g., digoxin, milrinone) 70% 30% 48% 52%
18. Benzodiazepines in patients over 65 (e.g., alprazolam) 50% 50% 34% 66%
19. Oral hypoglycemic agents (e.g., glipizide) 27% 73% 19% 81%
20. Low molecular weight heparin 61% 39% 54% 46%
Specific Medications Yes No Yes No
22. Warfarin 79% 21% 63% 38%
23. IV heparin 85% 15% 75% 25%
24. Subcutaneous insulin 74% 26% 66% 34%
25. IV insulin 89% 11% 77% 23%
26. IV magnesium sulfate 71% 29% 58% 42%
27. IV calcium gluconate 65% 35% 52% 48%
28. IV calcium chloride 65% 35% 52% 48%
29. IV potassium phosphate 89% 11% 73% 27%
30. IV potassium chloride 96% 4% 87% 13%
31. Hypertonic sodium chloride injection 92% 8% 75% 25%
32. High concentration dextrose injection 62% 38% 46% 54%
33. IV theophylline 55% 45% 44% 56%

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