APSF developed a new paradigm based on 3 principles:
standardization, technology, and prefilled or premixed
medications.6 These principles emphasize not only areas
in which safety has been lacking but also opportunities
for growth and development.
• Standardization of High-Alert Medications.
Medications such as phenylephrine or ephedrine should
be prepared by a pharmacy to ensure that the syringes
and infusions have a standardized concentration and
label.6 When prepared by anesthetists, high-alert drugs
can be prepared in different strengths depending on
provider preference, and this practice can easily result in
administration errors, especially when a second provider
administers the drug. The standardization of high-alert
medications will eliminate the potential for error when
diluting and preparing medications and will increase the
safety of the patients and staff.
• Standardization of Workspace. Standardization also
refers to the anesthesia workspace in terms of the arrangement
of the medications and equipment. Organizing
drug trays to eliminate the proximity of sound-alike or
look-alike medications will help decrease the number of
ADEs. The removal of rarely used medications from the
workspace will help reduce the potential to prepare and
administer the wrong medication. A pharmacy located
in the surgical area can be beneficial in developing and
maintaining medication trays and in dispensing the
less common medications.14