A Step Forward for Medical Safety: New Guidelines for 2024-2025 from ISMP

Institute for Safe Medication Practices (ISMP)

PLYMOUTH MEETING, PA — The Institute for Safe Medication Practices (ISMP), a leading authority in medication error prevention, has revealed its updated recommendations for hospitals to bolster their medication safety practices for the period of 2024-2025. The latest guidelines spotlight recurring challenges, which, despite former alerts, persist in causing harmful and sometimes fatal errors. These new Best Practices are envisioned to stimulate a nationwide response for their prevention.

Most noteworthy among the new Best Practices from ISMP are measures to prevent errors related to the administration of tranexamic acid, to intercept mistakes during transitions in care, and to mitigate risks associated with the application of vaccines both in inpatient and associated outpatient settings. Christina Michalek, the Director of Membership and Patient Safety Organization (PSO), urges hospitals and health systems to scrutinize this novel set of Best Practices and prioritize their implementation.

Tranexamic acid, an antifibrinolytic agent used to control bleeding, has been identified as a significant risk factor for wrong-route errors. When erroneously administered intrathecally, it may act as a powerful neurotoxin, almost invariably causing harm and even resulting in high mortality rates. Actions such as color-coding labels and differentiating vial sizes have mitigated some risks, but the potential for cap color confusion remains, especially when vials are stored in close proximity. Implementing barcode scanning in areas where mix-ups frequently occur, like perioperative areas and emergency departments, is one of the strategies suggested to lower the incidence of errors with this medication.

Another focal area of the new guidelines is ensuring the prevention of medication errors during transitions of care. These transitions are often riddled with discrepancies in medication histories, and incomplete or inaccurate medication reconciliation can lead to serious errors. The ISMP is recommending specific and precise processes for collecting, verifying, and reconciling medication histories, which can in turn greatly enhance the safety of patient care handoffs.

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The ISMP also addresses vaccine-related mistakes in inpatient and associated outpatient settings. Analysis of error reports has revealed recurring factors contributing to mistakes, such as confusion with age-specific formulations, errors with combination vaccines, wrong route administration, and the administration of invalid or expired vaccines. The prime goal is to reduce these risks and ensure that patients receive proper protection against serious diseases.

These new Best Practices result from thorough scrutiny of error reports received by ISMP, vetted by an external expert advisory panel and approved by the ISMP Board of Directors. Since 2014, ISMP’s Best Practices have been shaping realistic goals for healthcare institutions around the country, providing them with practical, achievable strategies to enhance medication safety. The latest update represents another crucial stride in advancing patient safety and quality of care in the healthcare sphere.

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