ISMP Releases 2025-2026 Targeted Medication Safety Best Practices for Community Pharmacy

New Best Practices Focus on Weight-Based Dosing, Return-to-Stock Process, Vaccine Administration

The Institute for Safe Medication Practices (ISMP) has launched its second set of specific, consensus-based guidance to help prevent persistent medication safety issues in the community and ambulatory pharmacy settings, along with a worksheet to assist with implementation.

ISMP’s 2025-2026 Targeted Medication Safety Best Practices for Community Pharmacy identify key areas where greater action is needed and provide practical recommendations that have already been adopted by numerous healthcare organizations. While they are targeted for the community/ambulatory pharmacy setting, some Best Practices are also applicable to other healthcare settings, such as mail order, specialty pharmacy, home infusion, medical offices, and clinics.

The new practices added to the 2025-2026 Best Practices address how to:

• Obtain and use a patient's weight to verify dosing of weight-based medications
• Maximize the use of technology to prevent errors during the return-to-stock (RTS) process
• Establish standard processes to prevent errors during vaccine preparation and administration

“ISMP encourages community pharmacies to focus their medication safety efforts for the next two years on the Best Practices,” says Michael J. Gaunt, PharmD, Senior Manager for Error Reporting Programs. “Identifying gaps in safety practices and developing an action plan to address any vulnerabilities is crucial to reduce the risk of medication errors and protect patients from preventable harm.”

Additional Best Practices featured in the 2025-2026 guidelines that were retained from previous years include:

• Preventing wrong patient errors when filling prescriptions, responding to questions, and administering vaccines
• Expanding and maximizing the use of barcode scanning during medication and vaccine dispensing and administration 
• Avoiding errors involving inadvertent daily dosing of methotrexate for non-cancer indications 
• Standardizing the use of metric (mL) units of measure when prescribing, dispensing, and measuring oral liquid medications 
• Using information about medication safety risks and errors that have occurred in other organizations to take preventative action 

ISMP launched its Targeted Medication Safety Best Practices for Hospitals in 2014. As with the acute care version, the community pharmacy Best Practices are updated as needed every two years. While they may be challenging for some organizations to achieve, they are designed to be practical and realistic. Best Practices are reviewed by an outside Expert Advisory Panel, grounded in scientific research and/or expert analysis of medication errors and their causes, and represent high-leverage error-reduction strategies.

For a copy of ISMP’s 2025-2026 Targeted Medication Safety Best Practices for Community Pharmacy, visit: Targeted Medication Safety Best Practices for Community Pharmacy

For a worksheet that can help community pharmacies analyze and document their current status with implementing the Best Practices and identify opportunities for improvement, visit: Worksheet for the ISMP Targeted Medication Safety Best Practices for Community Pharmacy

About the Institute for Safe Medication Practices

The Institute for Safe Medication Practices (ISMP) is the nation’s first 501c (3) nonprofit organization devoted entirely to preventing medication errors. ISMP is known and respected for its medication safety information. For more than 25 years, it also has served as a vital force for progress. ISMP’s advocacy work alone has resulted in numerous necessary changes in clinical practice, public policy, and drug labeling and packaging. Among its many initiatives, ISMP runs the only national voluntary practitioner medication error reporting program, publishes newsletters with real-time error information read and trusted throughout the global healthcare community, and offers a wide range of unique educational programs, tools, and guidelines. In 2020, ISMP formally affiliated with ECRI to create one of the largest healthcare quality and safety entities in the world, and ECRI and the ISMP PSO is a federally certified patient safety organization by the U.S. Department of Health and Human Services. As a watchdog organization, ISMP receives no advertising revenue and depends entirely on charitable donations, educational grants, newsletter subscriptions, and volunteer efforts to pursue its lifesaving work. Visit ISMP and follow @ismp_org to learn more.