Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. e21-e25 (doi:10.1542/peds.2004-2452)
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ELECTRONIC ARTICLE

Standard Drug Concentrations and Smart-Pump Technology Reduce Continuous-Medication-Infusion Errors in Pediatric Patients

Gitte Y. Larsen, MD, MPH*,{ddagger}, Howard B. Parker, PhD*, Jared Cash, PharmD*, Mary O’Connell, RN, BSN* and MaryJo C. Grant, PNP, PhD*

* Primary Children’s Medical Center, Salt Lake City, Utah
{ddagger} Department of Pediatrics, University of Utah, Salt Lake City, Utah

Objective. To determine if combining standard drug concentrations with "smart-pump" technology reduces reported medication-infusion errors.

Design. Preintervention and postintervention comparison of reported medication errors related to infusion therapies during the calendar years 2002 and 2003.

Setting. A 242-bed university-affiliated tertiary pediatric hospital.

Intervention. Change in continuous-medication-infusion process, comprising the adoption of (1) standard drug concentrations, (2) "smart" syringe pumps, and (3) human-engineered medication labels.

Main Outcome Measures. Comparison of reported continuous-medication-infusion errors before and after the intervention.

Results. The number of reported errors dropped by 73% for an absolute risk reduction of 3.1 to 0.8 per 1000 doses. Preparation errors that occurred in the pharmacy decreased from 0.66 to 0.16 per 1000 doses; the number of 10-fold errors in dosage decreased from 0.41 to 0.08 per 1000 doses.

Conclusions. The use of standard drug concentrations, smart syringe pumps, and user-friendly labels reduces reported errors associated with continuous medication infusions. Standard drug concentrations can be chosen to allow most neonates to receive needed medications without concerns related to excess fluid administration.

Key Words: rule of six • intensive care unit • children • patient safety • medication errors

Accepted Jan 6, 2005.


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