July 2017

In this month’s issue:

  • The texting debate: Beneficial means of communication or safety and security risk?
  • 20th Annual ISMP Cheers Awards (submit nominations -
  • ISMP Survey on Texting Medical Orders ( - complete by August 31, 2017)

  • Suspect a medication error with unexplained symptoms.
  • Chlorhexidine mixed up with lidocaine oral solution
  • 25 sublingual nitroglycerin, all at once.
Special announcements:
  • OE/ISMP Just Culture Certification Course
    • Join ISMP and Outcome Engenuity (OE) for a unique Medication Safety Focused Just Culture Certification Course on August 2-4 in Wilmington, DE (30 minutes from Philadelphia International Airport). Participants will explore the core concepts of a Just Culture and become an expert in the Just Culture Algorithm. Attend the 3-day course and leave with the confidence to work and lead in a Just Culture. CE credit is available for pharmacists and nurses.
    • For details and to register, visit:

Report medication errors to ISMP. Share your medication safety stories and error reports in confidence by calling ISMP 1-800-FAILSAF(E), via our website (, or by email ( Reporter identity and location remain strictly confidential and are never published. Anonymous reports are also accepted. 

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