Practitioners will pay more attention to warnings that stem from expert and trusted sources, and if the consequences are easily imaginable or salient. When designing a new warning, determine the categories of practitioners who will most likely benefit from the warning, and design it in a way that takes into account the lowest level of ability, training, and experience of the target audience. 3 Some of the conclusions drawn by Wogalter and other experts are provided below as examples of ways to improve the design and delivery of medication-related warnings. Wogalter, a leading international authority on warning design and use, has compiled important contributions to this field of research in a book, Handbook of Warnings. Over the past few decades, a sizable body of research has been amassed about how to design effective warnings. Thus, warnings must be sufficiently conspicuous to capture attention, appropriately placed so their usefulness is maximized, and possess characteristics that encourage encoding of the content and action to avoid the risk.3 If practitioners do not notice the warning, it will go unheeded if they do not understand the risk, they might dismiss it and believe it has no importance if they are aware of the risk but do not know how to avoid it, they might be frustrated if they understand the risk and how to avoid it but believe the consequences are unimportant, they might not comply with the warning or may believe it is not worth the effort. 2,3 With few exceptions, practitioners will not typically search for or seek out warnings. ![]() Several design factors influence whether the warning is noticed, encoded (e.g., read/heard, understood, personalized, believed, stored in memory), and acted upon to avoid the hazard. To be effective, warnings must: 1) reach their target audience 2) capture the attention of recipients at the right time 3) cause recipients to understand the risk, believe that the warning relates to them, and understand the actions they need to take and 4) lead the recipients to respond appropriately. Recommendations to improve the design, delivery, and effectiveness of medication-related warnings are discussed in further detail below. While warning systems are considered mid-level strategies because they mostly involve efforts to inform and influence behavior, they can be an extremely valuable tool to help reduce the risk of potentially serious errors when they are well designed and accompanied by high-leverage, system-level risk-reduction strategies. ![]() 2 Another is whether the warnings truly inform practitioners about crucial medication safety issues and influence their behavior in ways intended to improve safety. ![]() How the components of the warning system interact and complement each other is one significant aspect of an effective medication-related warning system. The different components of the warning system may be intended for different audiences and may be embedded in different phases of the medication use process to ensure all who are involved with the neuromuscular blocking agent are aware of this critical information. ![]() For example, the warning system for a neuromuscular blocking agent, which is intended to alert practitioners to the drug’s effect of respiratory arrest and the need for ventilation, may include: a statement about the risk in the package insert a warning statement on the carton, immediate container label, and ferrule of the vial an auxiliary warning label on product storage locations and vials/infusions an interactive electronic warning that requires verification that the patient will be ventilated before removing the drug from an automated dispensing cabinet (ADC) and a visual/audible warning when the product’s barcode is scanned and the drug has not been prescribed for that patient. The warning system may also include several components that complement each other and various forms of technology. The warning system may ask the recipient to choose between two or more courses of action, present only one safe option, or provide information only. Medication-related warning systems are often used to inform both practitioners and consumers about new risks, or remind them about known risks associated with the use of medications.
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