Evaluating Knowledge Attitudes and Practices Regarding High-Alert Medications among Healthcare Professionals in a Tertiary Care Setting

Authors

DOI:

https://doi.org/10.31632/g3cj2396

Keywords:

Healthcare Professionals, High-Alert Medication, Medication Safety, Knowledge Attitude Practice (KAP)

Abstract

High-Alert Medications (HAMs) pose a high risk of patient harm if used improperly. This study assessed the knowledge, attitudes, and practices (KAP) of 143 healthcare professionals regarding HAMs at a tertiary care hospital in Palakkad, Kerala. Using a validated bilingual questionnaire, responses from nurses, pharmacists, doctors, and allied staff were analysed. Most participants (79%) were nurses. While positive attitudes (mean: 21.6 ± 2.86) and good practices (mean: 6.4 ± 2.87) were observed, knowledge levels were moderate (mean: 3.2 ± 0.61), with 70% categorized as having low knowledge. Profession showed a marginal association with knowledge (χ² = 13.78, p = 0.055), but neither attitude nor practice significantly predicted knowledge in logistic regression analysis. Despite favourable attitudes and self-reported practices, limited knowledge, especially among nurses, highlights a critical gap. The findings emphasize the need for profession-specific education to enhance awareness and ensure the safe handling of HAMs.

References

Aljadhey, H., Mahmoud, M. A., Mayet, A., Alshaikh, M., Ahmed, Y., Murray, M. D., & Bates, D. W. (2013). Incidence of adverse drug events in an academic hospital: A prospective cohort study. International Journal for Quality in Health Care, 25(6), 648-655. https://doi.org/10.1093/intqhc/mzt075

Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: A systematic review. Drug Safety, 43(6), 517-537. https://doi.org/10.1007/s40264-020-00918-3

Alsulami, Z., Conroy, S., & Choonara, I. (2013). Medication errors in the Middle East countries: a systematic review of the literature. European Journal of Clinical Pharmacology, 69(4), 995-1008. https://doi.org/10.1007/s00228-012-1435-y

Chakraborty, D. S., Kar, B., Choudhury, S., Ghosh, A., Samanta, K., & Hazra, A. (2022). Knowledge, attitude and practice survey regarding high alert medication among resident doctors in a tertiary care teaching hospital in Eastern India. Current Drug Safety, 17(4), 375-381. https://doi.org/10.2174/1574886317666220207123704

Hilowle, F. M., Mohamud, F. A., Osman, I. M., Mohamud, S. M., Doğan, S., Sahal, S. M., & Aden, S. A. (2025). Knowledge Level and Attitudes of Healthcare Professionals Regarding Patient Safety in a Tertiary Hospital in Somalia: A Cross-Sectional Study. Drug, healthcare and patient safety, 17, 173–180. https://doi.org/10.2147/DHPS.S507870

Hu, L., & Jiang, W. (2024). Assessing perceptions of nursing knowledge, attitudes, and practices in diabetes management within Chinese healthcare settings. Frontiers in Public Health, 12, 1426339. https://doi.org/10.3389/fpubh.2024.1426339

Institute for Safe Medication Practices (ISMP). ISMP list of high-alert medications in acute care settings. ISMP; 2024. Available at https://www.ismp.org/sites/default/files/attachments/2024-01/20240111.pdf

Joint Commission IDs five high-alert meds. (2000). ED management: The monthly update on emergency department management, 12(2), 21–22.

Liao, X., Nguyen, T. P. L., & Sasaki, N. (2022). Use of the knowledge, attitude, and practice (KAP) model to examine sustainable agriculture in Thailand. Regional Sustainability, 3(1), 41-52. https://doi.org/10.1016/j.regsus.2022.03.005

Mallah, N., Rodriguez-Cano, R., Figueiras, A., & Takkouche, B. (2020). Design, reliability and construct validity of a Knowledge, Attitude and Practice questionnaire on personal use of antibiotics in Spain. Scientific Reports, 10(1), 20668. https://doi.org/10.1038/s41598-020-77769-6

Manias, E., Williams, A., & Liew, D. (2012). Interventions to reduce medication errors in adult intensive care: a systematic review. British Journal of Clinical Pharmacology, 74(3), 411-423. https://doi.org/10.1111/j.1365-2125.2012.04220.x

Mohamed, A. H., Abbassi, M. M., & Sabry, N. A. (2024). Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt:“cross-sectional observational study”. BMC Medical Education, 24(1), 390. https://doi.org/10.1186/s12909-024-05367-5

Santos, O. P. D., Melly, P., Hilfiker, R., Giacomino, K., Perruchoud, E., Verloo, H., & Pereira, F. (2022). Effectiveness of educational interventions to increase skills in evidence-based practice among nurses: The editcare systematic review. Healthcare, 10(11), 2204. https://doi.org/10.3390/healthcare10112204

Teoh, K. W., Ng, C. M., Chong, C. W., Bell, J. S., Cheong, W. L., & Lee, S. W. H. (2023). Knowledge, attitude, and practice toward pre-diabetes among the public, patients with pre-diabetes and healthcare professionals: A systematic review. BMJ Open Diabetes Research & Care, 11(1). https://doi.org/10.1136/bmjdrc-2022-003203

van Huizen, P., Wembridge, P., Russo, P. L., Manias, E., & Connell, C. J. (2025). Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study. International Journal of Nursing Studies Advances, 8, 100331. https://doi.org/10.1016/j.ijnsa.2025.100331

Wolf, Z. R., Hicks, R., & Serembus, J. F. (2006). Characteristics of medication errors made by students during the administration phase: A descriptive study. Journal of Professional Nursing, 22(1), 39-51. https://doi.org/10.1016/j.profnurs.2005.12.008

World Health Organization (2017). Medication Without Harm‐Global Patient Safety Challenge on Medication Safety. World Health Organization. https://www.who.int/initiatives/medication-without-harm

Published

2026-01-31

How to Cite

Evaluating Knowledge Attitudes and Practices Regarding High-Alert Medications among Healthcare Professionals in a Tertiary Care Setting. (2026). International Journal of Sustainable Biome and Life Care, 2(2), 1-9. https://doi.org/10.31632/g3cj2396