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Related Experiment Videos

Variability in intravenous medication practices: implications for medication safety.

David W Bates1, Timothy Vanderveen, Diane Seger

  • 1Division of General Internal Medicine, Brigham and Women's Hospital, Boston, USA. dbates@partners.org

Joint Commission Journal on Quality and Patient Safety
|May 26, 2005
PubMed
Summary

Intravenous (i.v.) drug administration shows significant variation across hospitals, increasing patient safety risks. Standardization of these practices is crucial for improving i.v. medication safety and reducing harm.

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Area of Science:

  • Medical device technology
  • Clinical pharmacy
  • Patient safety

Background:

  • Infusion devices allow programming of "best practice" rules for intravenous (i.v.) drug administration.
  • Alerts can be triggered for dosages outside pre-established limits.
  • High variation in medical care can pose safety risks if unnecessary.

Purpose of the Study:

  • To assess variation in intravenous drug administration practices across hospitals.
  • To identify differences in drug naming, concentrations, dose units, limits, and administration.

Main Methods:

  • Compared i.v. best practice data sets for drugs from 100 hospitals using a single manufacturer's infusion devices.
  • Analyzed drug names, concentrations, dose units, dose limits, and administration practices.

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Main Results:

  • Hospitals averaged 64 drugs and 113 drug/concentration combinations.
  • Significant variation in drug names (e.g., 45 names for amiodarone), concentrations, and dosage units was observed.
  • Dose limits varied substantially and were often indication-dependent.

Conclusions:

  • Unnecessary variation in i.v. medication practices likely increases patient harm.
  • Standardization of i.v. medication practices holds significant potential to enhance patient safety.