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Intralipid medication errors in the neonatal intensive care unit.
John Chuo1, George Lambert, Rodney W Hicks
1University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, USA. chuojo@umdnj.edu
Joint Commission Journal on Quality and Patient Safety
|March 21, 2007
Summary
Most intralipid errors occur during IV pump administration, particularly when nurses are busy or during shift changes. Improving infusion device programming and workflow analysis can help prevent medication dosing errors.
Area of Science:
- Medical Error Research
- Patient Safety
- Nursing Practice
Background:
- Intralipid administration is a complex process with potential for medication errors.
- Intravenous (IV) pumps are frequently used, increasing the risk of programming and dosing errors.
- Nursing workload and time of day, especially shift changes, are critical factors influencing error occurrence.
Purpose of the Study:
- To identify the primary phase of intralipid administration where errors occur.
- To investigate the relationship between nursing workload, time of day, and intralipid dosing errors.
- To propose strategies for preventing intralipid administration errors.
Main Methods:
- Analysis of intralipid administration workflow.
- Identification of error opportunities during the administration phase.
- Consideration of nursing workload and time-of-day factors.
- Potential use of smart pump technology for error tracking.
Main Results:
- Most intralipid errors are linked to the administration phase, particularly IV pump programming.
- High nursing workload and evening shift changes are associated with increased dosing errors.
- Error rates are influenced by opportunities for error during administration.
Conclusions:
- Intralipid administration errors are predominantly linked to the IV pump administration phase.
- Targeted interventions focusing on workflow, nurse workload, and smart pump technology are crucial for error prevention.
- A comprehensive error prevention plan requires hospital leadership commitment and healthcare provider cooperation.
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