Certified Professional in Patient Safety (CPPS) Practice Exam

According to the Institute for Safe Medication Practices (ISMP), why should manual independent double checks (IDCs) be used selectively?

1. Given the workload, staff do not have time for IDCs on all high-alert medications.

2. Research has shown that IDCs are not effective.

3. Reversal agents for medication overdoses are widely available.

4. Computerized prescriber order entry has greatly reduced medication errors.

The correct answer is: Given the workload, staff do not have time for IDCs on all high-alert medications.

The use of manual independent double checks (IDCs) should be approached selectively primarily due to the consideration of healthcare staff workload and the practicalities of clinical practice. High-alert medications, which are medications associated with a higher risk of causing significant harm when used incorrectly, certainly warrant careful scrutiny; however, requiring IDCs on all of these medications can lead to inefficiencies and increased workload. When staff are overwhelmed with tasks, there's a risk that they may become distracted or rushed, which could unintentionally lead to errors despite the presence of IDCs. Therefore, implementing selective IDCs allows healthcare providers to focus their efforts on those high-alert medications that pose the greatest risk, while also maintaining their capacity to provide safe and effective care overall. This strategic approach helps ensure that double checks are used judiciously where they are most needed, thereby enhancing patient safety without unnecessarily burdening the staff. In this context, other choices do not provide as compelling a rationale for the selective use of IDCs. For instance, the effectiveness of IDCs is not discounted in the same way by researched findings, and while computerized systems certainly contribute to reducing errors, they do not eliminate the need for vigilance in medication administration.