Training Requirement: High-Risk Medicines

Last Updated: 24 September 2023

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This article is part of our Training Requirement Series where we provide comprehensive guides to meet the actual training requirements that are often needed/requested of learning and development departments within Australia's healthcare organisations. This series includes both general requirements, such as high-risk medicines, but also focuses on the specific requirements stemming from the NDIS, Aged Care and NSQHS Quality Standards.

What are 'High-Risk Medicines'?

High-risk medicines are medicinal substances that hold a significant risk of causing patient harm or death if they are improperly used or administered. Such medicines require vigilant management to minimise associated risks.

The proper management of high-risk medicines is paramount within healthcare organisations. As mandated by NSQHS Action 4.15 and the Strengthened Aged Care Standards 5.3.5, comprehensive training and assessment measures are essential. This guide provides an in-depth roadmap for learning and development coordinators and focusing on implementing a training program.

Examples of High-Risk Medicines

Below are some examples of high-risk medicines:

  • Anticoagulants: e.g., Warfarin
  • Insulin and other hypoglycaemic agents
  • Opioids: e.g., Morphine, Fentanyl
  • Chemotherapy agents

What is the High-Risk Medicines Training Requirement?

Due to the intrinsic risks involved, there are specific training requirements for healthcare staff. These requirements comply with healthcare standards such as NSQHS and Strengthened Aged Care Standards. Any healthcare professional involved in prescribing, dispensing, administering, or monitoring these medicines needs comprehensive training and ongoing skill development.

Relevant Standards

Action 4.15: High-Risk Medicines

  • Organisations must ensure high-risk medicines are regularly assessed for; use and misuse, storage factors, prescribing, dispensing and administration
  • Evidence-based risk-reduction strategies are implemented for high-risk medicines

National Safety and Quality Health Service (NSQHS) Standards

Action 5.3.5: High-Risk Medications Management:

  • Providers must implement processes to identify, monitor, and mitigate risks to older people associated with high-risk medication usage. This includes reducing inappropriate use of psychotropic medicines

Strengthened Quality Standards framework analysis - Aged Care Quality Standards

Failure to comply with the requirements could lead to an organisation being penalised or reprimanded.

High-Risk Medicines Skills Required for Healthcare Staff

The management of high-risk medicines is not simply about identifying them. The following skills are crucial for staff:

Female clinical professional preparing administration of medicine
Skill Key Elements
Pharmacological Understanding

Comprehensive knowledge of pharmacokinetics and pharmacodynamics for accurate dosage and timely administration.

Proper Storage and Administration

Mastery of protocols related to safe storage and appropriate administration techniques, including contraindications and proper use of delivery systems like syringes and infusion pumps.

Monitoring for Adverse Events

Capability to recognise signs of toxicity or adverse drug interactions, coupled with swift intervention strategies.

Documentation and Compliance

Expertise in maintaining meticulous records for legal and clinical safety reasons, while strictly adhering to privacy regulations and other guidelines set by bodies like the Australian Commission on Safety and Quality in Health Care.

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How to Assess Staff Competency in High-Risk Medicines

Ensuring competency involves a multi-faceted approach to ensure patient safety and compliance to the standards are upheld:

  • Written Exams: These could range from multiple-choice questions to case-based scenarios to test theoretical knowledge.
  • Practical Evaluations: Hands-on assessment to measure aptitude in drug preparation, administration, and patient monitoring. Observational tools aligned with organisational guidelines can be used.
  • Peer Reviews: A 360-degree feedback mechanism involving colleagues, superiors, and sometimes patients can provide a holistic view of one's competency.

Strategies to Support Healthcare Staff Improve High-Risk Medicines Skills

Creating a culture of learning and safety on high-risk medications safety is vital. Once staff competency levels are identified, targeted training interventions can be formulated.

Here are some potential strategies:

  • Educational Workshops: Regularly updated workshops can refresh staff knowledge and introduce new best practices.
  • Mentoring Programs: Pairing less experienced staff with seasoned professionals for one-on-one training.
  • Open Communication: Establish reporting mechanisms for medication errors and adverse events, where staff can share experiences without fear of punitive action.

Sample Training Plan for the High-Risk Medicines Training Requirement

Using the below competency assessment on high-risk medicines, we can tailor a training plan to target the specific staff skills gaps.

Staff Competency assessment on clinical handover

Based on the results - "pharmacology" knowledge and "storage and administration" of medicines are the skills that require actioning.

Quarter Topics Resources
Q1 Pharmacology
Q2 Proper Storage and Administration

Need high-risk medications training for your organisation?

Contact Ausmed today and see how we can support with your high-risk medications requirements!

Staff Competency Assessment for High-Risk Medicines - Example

The following is an example survey that learning and development coordinators and other educational managers may use to asses staff competency on high-risk medications.

Staff Survey - High-Risk Medicines Competency

  1. Do you know what high-risk medicines are?

    • 1. Yes
    • 2. Somewhat
    • 3. No

  2. Can you name three examples of high-risk medicines?

    • [Answer here]

  3. Are you familiar with the proper storage conditions for high-risk medicines?

    • 1. Yes
    • 2. Somewhat
    • 3. No

  4. How do you report an adverse event related to high-risk medicines?

    • [Answer here]

  5. Are you aware of the protocols for administering high-risk medicines?

    • 1. Yes
    • 2. Somewhat
    • 3. No

  6. Have you ever been evaluated for your competency in handling high-risk medicines?

    • 1. Yes
    • 2. Somewhat
    • 3. No

  7. Do you feel adequately trained to handle high-risk medicines?

    • 1. Yes
    • 2. Somewhat
    • 3. No


Ensuring the safe management of high-risk medicines is a multi-disciplinary effort requiring comprehensive training, assessment, and continuous improvement. By aligning organisational protocols with national standards, healthcare providers can significantly mitigate risks, enhance patient safety, and improve overall healthcare outcomes.


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