Standardized neonatal continuous infusion concentrations: A quality improvement initiative

• Published in: American journal of health-system pharmacy Vol. 80; no. 2; pp. 61 - 67
• Main Authors: Mulvihill, Christine, McDonald, Danielle
• Format: Journal Article
• Language: English
• Published: England 05.01.2023
• Subjects: Child; Humans; Infant, Newborn; Infusion Pumps; Infusions, Intravenous; Intensive Care Units, Pediatric; Medication Errors - prevention & control; Patient Safety; Quality Improvement; intravenous infusions; infusion pumps; neonatal nurses; neonatology; pharmacists; medical order entry systems
• ISSN: 1079-2082; 1535-2900
• DOI: 10.1093/ajhp/zxac299

Medication errors are a significant and preventable source of patient harm, especially in the neonatal population. Standardized infusion concentrations increase patient safety and streamline the workflow for pharmacists, nurses, and physicians. Neonatal continuous infusion concentrations were standardized and implemented into the electronic health record using an automated order panel. Pre- and postimplementation data were collected to assess the impact of this quality improvement initiative. The primary endpoint was the proportion of neonatal intensive care unit infusion orders that were compatible with "bolus from infusion" functionality in the syringe pump. Before implementation, only 40% of eligible infusions were compatible with the "bolus from infusion" function, compared to 93% after implementation (P < 0.00001). Within the syringe pump, the ratio of total options to the number of concentrations per medication was reduced by 31%. Implementation of an order panel with defaulted standard infusion concentration selection improved workflow and optimized technology in the neonatal intensive care unit.