High-alert medications: shared accountability for risk identification and error prevention.
Paparella S. High-alert medications: shared accountability for risk identification and error prevention. Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association. 2010;36(5):476-8. doi:10.1016/j.jen.2010.05.006.
This article describes how lack of communication around a near miss involving a high-alert medication led to a never event. The author suggests that heightened clinician awareness of risks and potential errors could protect against adverse events.