ISMP Targeted Best Practices: Frequently Asked Questions

Monday, September 26, 2016 5:59:21 AM

The ISMP Targeted Best Practices, updated this year, are an essential set of guidelines for medication safety. These have been published in response to repeated patient harm events that continue to occur despite warnings by ISMP in newsletters and other alerts.

In the September 8th edition of the Acute Care Medication Safety Alert, ISMP announced new and revised FAQs about the Targeted Best Practices had been posted on their website ( Some of the changes to be aware of include:

BEST PRACTICE #7: Clarification that although sealed, lock-lidded containers are expected for neuromuscular blocker (NMB) storage in general, in Anesthesia it would be acceptable to keep them together in a clearly labeled and segregated area of the cart drawer.

BEST PRACTICE #9: Reinforcement that it is the responsibility of the individual hospital to determine which reversal agents are made readily available, and illustration of example ‘coupled order sets' to facilitate the timely administration of these agents (naloxone with opioid orders, hypoglycemia protocol with insulin orders, epinephrine and steroids for drugs with known anaphylactic reactions).

BEST PRACTICE #10: Description of various strategies to avoid the use of one liter Sterile Water bags for humidification with ventilators (two liter bags on a sturdier IV pole with proper labeling, systems that take hard-sided bottles, passive humidification systems).

All practice sites are encouraged to review these FAQs. They may provide further guidance as you implement the Targeted Best Practices at your facility.   Implementing strategies to enhance medication safety is one of pharmacy leadership’s most important priorities. What are some strategies you’ve undertaken? What questions do you have?