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MEDICATION USE: Ensure the safe use of high‐risk medications.

The Medication Use ROPs are:

1. Concentrated electrolytes – Not applicable for Menno Home/Hospital.
2. Heparin safety – The availability of heparin products is evaluated and limited to ensure that formats with the potential to cause patient safety incidents are not stocked in client service areas.
3. High‐alert medications – A documented and coordinated approach to safely manage high‐alert medications is implemented.
4. Narcotic safety – The availability of narcotic products is evaluated and limited to ensure that formats with the potential to cause patient safety incidents are not stocked in client service areas.

Surveyor Question: At Menno Place, how does the organization ensure that abbreviations, symbols, and dose designations are not used on any written, printed or electronic materials?

Evidence:

• “Do Not Use” Abbreviation List is on each unit and easily available.
• Every item on the “Do Not Use” Abbreviation List is no longer on any written, printed, or electronic document.
• Staff and physicians are made aware of the “Do Not Use” Abbreviation List and the policy.
• Preprinted orders are reviewed annually and are free of “Do Not Use” abbreviations. There are no “Do Not Use” Abbreviations present on any written, printed or electronic documents.
• Audits are completed regularly to ensure the “Do Not Use” Abbreviations are not used.

Heparin Safety and Medication Concentrations

Heparin is identified as a high alert medication that is an area of focus for safety.

Surveyor Question: How does your organization ensure that heparin concentrations are standardized and limited?

Evidence:

• Our organization uses manufactured products in pre-filled pharmacy unit doses.
• We do not store high-dose heparin products.
• Audits are completed annually, to ensure no high-dose heparin products are present on the units.

 Narcotic Safety

Narcotics are identified as high alert medications for safety reasons. Limiting different doses of narcotics, ensuring restricted access, as well as educating staff on their use reduces medication errors.

Surveyor Question: How does your team ensure that narcotics are stored and used safely?

Evidence:

• All narcotics are stored in a locked narcotic cupboard.
• Two nurses are required to count narcotics.
• A nurse is responsible for the keys to the narcotics cupboard.
• The Medical Medication Safety Advisory Committee (MMSAC) reviews medications stocked in contingency, ensuring no high dose narcotics are on-site.
• Audits are completed ensuring high dose narcotics are not stocked in med rooms.