Table 3. Definition of each best Practice (adapted from the Institute for Safe Medication Practices).

1: “Three New Best Practices in the 2022-2023 Targeted Medication Safety Best Practices for Hospitals | Institute for Safe Medication Practices.” (2022). Accessed: August 14, 2023: https://www.ismp.org/resources/three-new-best-practices-2022-2023-targeted-medication-safety-best-practices-hospitals.

2: “Survey Shows Room for Improvement with Three New Best Practices for Hospitals | Institute for Safe Medication Practices.” (2022). Accessed: August 14, 2023: https://www.ismp.org/resources/survey-shows-room-improvement-three-new-best-practices-hospitals#:~:text=The%20three%2....

Number of best practices	Description of best practice
1	Dispense vincristine and other vinca alkaloids in a minibag of a compatible solution and not in a syringe
2	Use a weekly dosage regimen default for oral methotrexate in electronic systems when medication orders are entered
	Require a hard stop verification of an appropriate oncologic indication for all daily oral methotrexate orders
	Provide specific patient and/or family education for all oral methotrexate discharge orders
3	Weigh each patient as soon as possible on admission and during each appropriate outpatient or emergency department encounter
	Measure and document patient weights in metric units only
4	Ensure that all oral liquid medications that are not commercially available in unit dose packaging are dispensed by the pharmacy in an oral syringe or an enteral syringe
5	Purchase oral liquid dosing devices (oral syringes/cups/droppers) that only display the metric scale
6	Eliminate glacial acetic acid from all areas of the hospital
7	Segregate, sequester, and differentiate all neuromuscular blocking agents (NMBs) from other medications, wherever they are stored in the organization
8	Administer medication infusions via a programmable infusion pump utilizing dose error-reduction systems
	Maintain a 95% or greater compliance rate for the use of dose error-reduction systems
9	Ensure all appropriate antidotes, reversal agents, and rescue agents are readily available
	Have standardized protocols and/or coupled order sets in place that permit the emergency administration of all appropriate antidotes, reversal agents, and rescue agents used in the facility
10	Eliminate all 1,000 mL bags of sterile water (labeled for “injection,” “irrigation,” or “inhalation”) from all areas outside of the pharmacy
11	When compounding sterile preparations, perform an independent verification to ensure that the proper ingredients (medications and diluents) are added, including confirmation of the proper amount (volume) of each ingredient prior to its addition to the final container
12 (merged with BP 15)	Eliminate prescribing of fentanyl patches for opioid-naive patients and for patients with acute pain
13	Eliminate injectable promethazine from the formulary
14	Seek out and use information about medication safety risks and errors that have occurred in other organizations outside of your facility and take action to prevent similar errors
15	Verify and document a patient’s opioid status and type of pain before prescribing and dispensing extended-release and long-acting opioids
	Default order entry systems to the lowest starting dose and frequency when initiating orders for extended-release and long-acting opioids
	Eliminate the prescribing of fentaNYL patches for opioid-naïve patients and/or patients with acute pain
	Eliminate the storage of fentaNYL patches in automated dispensing cabinets or as unit stock in clinical locations where acute pain is primarily treated
16	Limit the variety of medications that can be removed from an automated dispensing cabinet (ADC) using the override function
	Require a medication order prior to removing any medication from an ADC, including those removed using the override function
	Monitor ADC overrides to verify appropriateness, transcription of orders, and documentation of administration
	Periodically review for appropriateness the list of medications available using the override function
17	Safeguard against errors with oxytocin use
18	Maximize the use of barcode verification prior to medication and vaccine administration by expanding use beyond inpatient care areas
19	Layer numerous strategies throughout the medication use process to improve safety with high-alert medications