Background JC Standards impose at hospitals organisation to develop a method to improve high risk drugs safety.

Purpose European Institute of Oncology (EIO) decided to develop this method improving the safety of high-alert drug government in order to reduce the occurrence of medication errors, with an impact on the quality of service provided and the patient quality of life.

Materials and methods The work was structured as follows: (1). Distribution, collection and analysis of a questionnaire on the perception of nurses about high-risk drugs and LASA. (2). Visits to eight units, representative of the care areas, with direct observation of preparation/administration of medications based on prescription. (3). Observation of primary and secondary packaging of 731 drugs in the EIO formulary. A list which shows all the possible confounders drugs (LASA) has been prepared.

Results Data of completed questionnaires (187–86.6% of 216) were revised to highlight the general trend of knowledge at units individual level. From visits were detected 21 findings, of which 15 non-compliance (NC) that have revealed structural problem, incomplete medical prescription, professional incorrect behaviours, lack of standardisation of the process of prescription/medication management, lack of narcotics and electrolyte concentrated procedures knowledge/compliance. Observation and comparison of EIO drugs packaging found that 15.7% of the 731 drugs may be classified as high alert (115) and 17.7% as LASA (130).

Conclusions With these assessments has been defined a general EIO procedure that governs the management of high-alert drugs in order to reduce medication errors and improve patient safety, with an impact on quality of provided service. It ‘was defined a list of drugs considered high risk at the EIO (heparin, concentrated electrolytes, insulin, etc..) and what hospital units are authorised for storage. In addition, the high-risk drugs are stored in appropriate red containers and it was defined specific areas for the high alert drugs storage.