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Decreasing errors in pediatric continuous intravenous infusions.

Christoph U Lehmann1, George R Kim, Renmeet Gujral

  • 1Johns Hopkins Children's Medical and Surgical Center, Baltimore, MD, USA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|April 1, 2006
PubMed
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A web-based calculator significantly reduced infusion ordering errors and eliminated high-risk mistakes in pediatric care. This system demonstrated a safe and viable method for computerized continuous pediatric infusion orders.

Area of Science:

  • Pediatric patient safety
  • Health informatics
  • Medication error reduction

Background:

  • Infusion ordering errors pose a significant risk in pediatric care.
  • Current ordering systems may contribute to medication errors.
  • A need exists for improved decision support in infusion ordering.

Purpose of the Study:

  • To assess the impact of a web-based calculator on infusion ordering errors.
  • To evaluate the frequency of errors in pharmacy infusion preparation.
  • To determine the effectiveness of a decision-support system in reducing pediatric infusion errors.

Main Methods:

  • A web-based calculator and decision-support system was introduced into the infusion ordering workflow.
  • Data on ordering errors were collected before and after system implementation.

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  • Pharmacy infusion preparation errors were monitored.

    • Main Results:

    • Calculator-generated orders showed an 83% reduction in errors compared to handwritten orders.
    • No high-risk errors (e.g., incorrect decimal, dose) were found in calculator-generated orders.
    • No errors were observed in 118 pharmacy infusion preparations.

    Conclusions:

    • Web-based calculators significantly decrease total and high-risk errors in pediatric infusion prescribing.
    • Computerized ordering systems are a safe and viable method for continuous pediatric infusions.
    • The study supports the adoption of such systems to enhance patient safety.