Since January 2019, ISMP has learned about 4 children who received vin CRIS tine erroneously by the intrathecal route of administration, each suffering a very painful death. Three of the children were from Guyana, and one was from Norway. The child from Norway had a brain tumor and was just 6 years...
Resource Library
Whether you have experienced a medication error in your organization or you are proactively implementing prevention strategies, you are not alone. Thousands of organizations worldwide have relied on ISMP's resources for institutional change to reduce errors on a daily basis. These resources are developed from ISMP's review of reports through its national error reporting programs, peer-reviewed articles in its publications, and/or consensus gathering summits on topics pertinent to specific errors or hazards. ISMP offers a wide range of downloadable and easy to use resources. Many are free.
All Resources
Medication-related warning systems are often used to inform both practitioners and consumers about new risks, or remind them about known risks associated with the use of medications. The warning system may ask the recipient to choose between two or more courses of action, present only one safe...
ISMP was shocked and saddened to learn that, once again, 1-4 a frontline healthcare practitioner has found herself on the receiving end of a criminal indictment after making a medication error that led to the tragic death of a patient. RaDonda Vaught, a 35-year-old registered nurse, was indicted on...
These newly revised guidelines support organizations in decision making and strategic planning for the safe use of Automated Dispensing Cabinets.
In academic teaching hospitals, medical residents typically enter most of the medication orders for patients using electronic prescribing (e-prescribing) systems. However, little is known about the association between the residents’ level of training and the frequency of medication prescribing...
The US Food and Drug Administration (FDA) approved LUMOXITI (moxetumomab pasudotox-tdfk) injection in September 2018. Lumoxiti is a CD22-directed cytotoxin indicated for the treatment of adult patients with relapsed or refractory hairy cell leukemia who received at least two prior systemic therapies...
Problem: National news recently exposed details about a 2017 fatal medication error that happened at a large, prestigious hospital after the Centers for Medicare & Medicaid Services (CMS) briefly placed its Medicare reimbursement status in jeopardy. The hospital’s status was quickly restored...
These guidelines provide strategies to present drug information safely in various electronic formats intended to mitigate the risk of medication errors.
This poster presents sample drug orders with "q.d." and "q.i.d." that show how those abbreviations can be confused, and emphasizes that they be spelled out for greater clarity.