High-Alert Medications in Long-Term Care (LTC) Settings

High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error (e.g., wrong drug, wrong dose, wrong route, wrong resident). Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to patients or residents.

Use ISMP's List of High-Alert Medications in Long-Term Care (LTC) Settings to determine which medications require special safeguards to reduce the risk of errors. Strategies may include: 

• Standardizing the ordering, storage, preparation, and administration of these products
• Improving access to information about these drugs
• Limiting access to high-alert medications
• Using auxiliary labels and automated alerts
• Employing redundancies such as automated or independent double checks when necessary (Note: manual independent double checks are not always the optimal error-reduction strategy and may not be practical for all of the medications on the list) 

Download the List

^{How to cite: Institute for Safe Medication Practices (ISMP). ISMP List of High-Alert Medications in Long-Term Care (LTC) Settings.  ISMP; 2021.}