Website spotlight: Avoiding use of contraindicated medications

Staff Development Weekly: Insight on Evidence-Based Practice in Education, April 27, 2012

The Joint Commission has three standards containing EPs that address medication contraindications.

The Joint Commission assigns direct impact requirements to EPs that are "likely to create immediate risks to patient safety." Two EPs have direct impact requirements: Medication Management standard MM.05.01.01, EP 9, and MM.06.01.01, EP 6. Organizations that are found by The Joint Commission to be noncompliant with direct impact EPs are subject to more intensive review and potentially a recommendation for an adverse accreditation decision. EPs for MM.05.01.01 require pharmacists to review medication orders for appropriateness.

Previously, EP 5 of former Medication Management standard 4.10 had lumped together a substantial list of items to be reviewed, from "appropriateness of the drug, dose, frequency, and route of administration" to "other relevant medication-related issues or concerns." The Joint Commission split the items from MM.4.10's EP 5 in 2008, renumbered the standard MM.05.01.01, and expanded the number of EPs from one to 11.

In package inserts, medication contraindications typically include the following verbiage: " is contraindicated in any patient who has shown a hypersensitivity to or any of its other ingredients."

Regarding MM.05.01.01, EP 4's review of the profile for "patient allergies or potential sensitivities" is separate from EP 9's review of "other contraindications." So, the term "other contraindications" excludes allergies and sensitivities.

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