High risk medicines resources
This page provides resources and a reference table of medication safety alerts, notices and guidance issued by the Australian states and territories and by international organisations using the APINCHS classification. There could be other more recent alerts, advice and guidance related to other medicines or practice areas which may be relevant to you or your organisation.
Safer prescribing, dispensing and use of insulin (AIP)
All insulin products are included within the active ingredient prescribing List of Medicines for Brand Consideration (LMBC) for the following reasons:
- Medicine with a narrow therapeutic index – High risk medicine
- Similarity in active ingredient names
- Differences in dosing regimens for same indications
- Differences in administration/delivery device.
Insulins are high-risk medicines with a high incidence of medication error and related harm if the incorrect insulin is inadvertently prescribed, dispensed and administered. Prescriptions should include both the insulin brand name and active ingredient name to support safer product identification and selection. This set of factsheets highlights the importance of including the insulin brand name, as well as other critical elements for safer prescribing, dispensing and use of insulin.
National Anticoagulant Incident Analysis report
Using this table of resources
To encourage practice monitoring and improvement, each high risk medicine and system is mapped to tools validated in Australia, including Medication Safety Self Assessment for Australian Hospitals 2015 and National Quality Use of Medicines (QUM) Indicators in Australian Hospitals 2014.
Safety alerts, notices and other guidance
Aims
The aim of alerts, notices and other guidance is to:
- Inform health services, clinicians and consumers about serious known medication risks and safety considerations
- Outline the action required to minimise risks
- Provide guidance and tools to minimise risk of high-risk medicines.
Responsibility
Each jurisdiction manages its own medication safety alerts (and/or notices).
The Therapeutic Goods Administration is responsible for:
- Product recalls
- Safety alerts
- Medicine shortages.
The National Safety and Quality Health Service (NHSQHS) Medication Safety Standard requires health service organisations to:
- Regularly assess the use and misuse of high-risk medicines, relating to storage, prescribing, dispensing and administration
- Develop and implement evidence-based risk-reduction strategies for high-risk medicines.
The Commission is responsible for developing alerts and guidance to support and guide health service organisations, clinicians and consumers on high-risk medicines.
Additional resources
General principles and useful resources for best practice in management of all high risk medicines, and relevant links to validated tools, are provided below:
- NSQHS Standard 4. Medication Safety
- NSQHS Standards Checklist for assessors - Reviewing paper-based National Standard Medication Charts
- NSQHS Standards Checklist for assessors - Reviewing information accessed and actioned by the governing body
- Clinical Excellence Commission (CEC) Medication safety and Quality: High-risk medicines
- NSW Therapeutic Advisory Group (NSW TAG) High Risk Medicines Protocols and Guidelines
- Government of South Australia, SA Health High risk medicines
- Government of Western Australia, Department of Health High risk medications policy
- Western Australia Therapeutic Advisory Group (WATAG) High-risk Drugs
- Department of Health Therapeutic Goods Administration
- Institute for Safe Medication Practices (ISMP) ISMP High-Alert Medications
- Institute for Safe Medication Practices (ISMP)
- Institute for Safe Medication Practice Canada
- NHS England medication safety resources