Related Experiment Video
Updated: Jun 17, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Implementation and evaluation of a comprehensive system to deliver pediatric continuous infusion medications with
Elora Hilmas1, Azizeh Sowan, Mohamed Gaffoor
1Department of Pharmacy GF-30, Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA. ehilmas@nemours.org
Purpose:
The development, implementation, and evaluation of a comprehensive pediatric medication management system based on computerized orders with standardized concentrations for pediatric continuous infusions are described.
Summary:
To attain the Joint Commission mandate of using a few standardized concentrations for pediatric continuous infusion medications, a multidisciplinary team at the University of Maryland Medical Center pediatric intensive care unit restructured the medication management of continuous infusions from the handwritten rule-of-6 method to computerized orders with standardized concentrations. Development of the new system required creating a mathematical algorithm to automatically produce two to four standardized concentrations for 39 continuous infusion medications used in pediatrics, incorporating mnemonics that represent standard drug concentrations into the pharmacy medication-processing system, designing a computerized provider-order-entry program, and introducing smart infusion pumps that were programmed with standardized concentrations. System creation and implementation were completed hospitalwide over 16 months. The system successfully determined two to four standardized concentrations for each continuous infusion medication and allowed application of consistent dose, weight, and fluid restrictions when determining standardized concentrations. Preimplementation and postimplementation evaluation revealed that the new system eliminated several types of medication errors and was well received by all health care team members in pediatrics units.
Conclusion:
A technology-based, scientific, comprehensive yet simplified solution to attain the Joint Commission mandate concerning standardized concentrations was developed, implemented, and evaluated. The system successfully determined a limited number of concentrations for each continuous infusion medication for pediatrics and improved safety by eliminating medication errors when delivering these medications.
Related Concept Videos
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
One-Compartment Model: IV Infusion
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
Parenteral Drug Delivery Systems: Injectables, Implants, and Infusion Devices
Pharmacokinetics in Pediatric Patients: Drug Excretion
Drug Dosing: Infants and Children

