High-alert medications
Drugs carrying a heightened risk of significant harm when used in error: insulin, opioids and other sedatives, anticoagulants, concentrated electrolytes (especially potassium chloride), chemotherapy, neuromuscular blocking agents, hypertonic saline. Safeguards: independent double check by a second nurse, standardized concentrations, smart pump limits, removal of concentrated potassium from unit stock, and reading the label three times. An independent double check means the second nurse verifies without being told what to expect.