{
  "abstract": "Background and Importance High-alert medications (HAMs) are those that, if used improperly, can cause serious harm or even death. Their appropriate management is a priority in healthcare due to their significant impact on patient safety. In this context, current practices related to the handling of HAMs were evaluated as a basis for implementing improvement actions.Aim and Objectives To evaluate the degree of implementation and compliance with safe practices in HAMs use in a tertiary care hospital. Moreover, identify areas with the greatest potential for improvement, and propose optimisation actions within the Pharmacy Department.Material and Methods Descriptive, cross-sectional study conducted in a tertiary hospital to assess the implementation of safety measures using a five-level evaluation scale. Data were collected through a questionnaire validated by the national institute for medication safety, which includes eight sections:one covering general practices for all high-risk medications and seven addressing specific safety practices for prioritised high-risk drug groups–neuromuscular blocking agents, intravenous potassium, insulin, non-oncological methotrexate, oral and parenteral antineoplastics, anticoagulants, and opioids.Results An uneven level of implementation was observed across drug groups. Antineoplastic agents showed the highest compliance (69.6%), followed by anticoagulants (62.8%), opioids (54.5%), and insulins (47.8%). General practices demonstrated moderate adherence (44.5%), while non-oncological methotrexate showed the lowest (8.7%). The main areas for improvement identified were the accurate identification and labelling of HAMs in ward stock, enhancement of prescribing alerts, and strengthening of staff education and training programs to reinforce medication safety across the institution.Conclusion and Relevance The analysis revealed specific shortcomings in certain areas. Notable proposals for improvement include the parameterisation in the electronic prescription module of the weekly regimen for non-oncological methotrexate, with alerts that detect prescriptions without folate supplementation. Improvements were also implemented in the storage and labelling circuit for intravenous potassium. This analysis has been very useful in order to detect critical points and to implement some of these improvements, thus contributing to strengthening patient safety from the Pharmacy Service.References and/or Acknowledgements 1. Institute for Safe Medication Practices. ISMP List of High-Alert Medications in Acute Care Settings. 2023. https://www.ismp.org2. Institute for Safe Medication Practices–Spain. High-Alert Medications Safety Self-Assessment Questionnaire. Madrid: Ministry of Health, Institute for Safe Medication Practices; 2024. https://apps.ismp-espana.org/mar/ficheros/cuestionario_mar_2024.pdfConflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "Á Bernabé Gonzalo"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "A De Frutos Soto"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "A Martín Roldán"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "A Guerreiro Caamaño"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "M Llorente Gómez"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "M Montero Lázaro"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "M Gomez Diaz"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "S Maganto Garrido"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "Á León García"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "V Prol Da Costa"
    },
    {
      "affiliations": [
        "Hospital Clínico Universitario De Valladolid- Spain, Hospital Pharmacy Department, Valladolid, Spain"
      ],
      "name": "MT Sanchez Sanchez"
    }
  ],
  "title": "5PSQ-130 Evaluation of safe practices in high-alert medications: areas for improvement and optimisation proposals",
  "uid": "b0799898-9ac8-5fce-89fb-7e22b1bf309b"
}