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Label all medications in procedural areas

Ambulatory Safety Monitor, October 20, 2005

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In 2006, ambulatory surgery centers (ASC) with JCAHO certification will need to comply with National Patient Safety Goal 3D on labeling medications. This new requirement says your organization must label all medications, medication containers, and other solutions on and off of the sterile field in all procedural settings.

Align policy and practice
Your policy may already reflect this goal, but do your practices echo its meaning? Check the gap between policy and practice, says Della M. Lin, MD, anesthesiologist and chief executive director of continuing medical education at Queen's Medical Center in Honolulu.

The category of "all medications" includes saline and irrigation solutions, says Lin. "The only exception to the rule is a medication that has been drawn up and used immediately," she says. Adhere to this goal in all procedural areas, including the operating room, intensive care unit, catheterization lab, imaging, etc.

Tips for compliance
Lin offers the following suggestions to help your staff meet compliance with goal 3D:

• Keep original medication containers accessible until the end of the case.
• Discard labeled containers at the end of the case.
• Make labeling simple. For example, before you buy a case of pens to use when marking labels, test the brand and make sure the pens write on plastic and other materials in your facility. If they don't work properly, staff may become frustrated and work around this requirement.
• Create an explicit policy and educate your staff about it.
• Review vulnerable look-alike medications and solutions and encourage staff to use extra caution with them.
• When in doubt, throw it out.

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