Implementation of standardized dosing units for i.v. medications

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Patient Safety

Background:

• Electronic health record implementation revealed variable dosing units for critical intravenous medications.
• Multiple dosing units were available for medications including epinephrine, isoproterenol, midazolam, nitroglycerin, norepinephrine, and phenylephrine.
• This variability posed a risk for medication errors in critical care settings.

Purpose of the Study:

• To describe the implementation of standardized dosing units for six intravenous medications at an academic medical center.
• To improve consistency and reduce potential dosing errors for critical care infusions.
• To evaluate the effectiveness of nursing education on compliance with new dosing standards.

Main Methods:

• A multidisciplinary group of intensive care unit providers discussed and selected a standardized dosing unit.
• The proposed standardization was presented to the pharmacy and therapeutics committee for approval.
• A nursing education plan was developed and administered prior to implementation.
• A pre- and post-implementation nursing survey assessed compliance and identified preferred dosing units.

Main Results:

• Key providers selected weight-based dosing (micrograms per kilogram per minute) for consistency in pediatric and adult patients.
• Nursing education was successfully completed to ensure safe administration under the new system.
• The study aimed to confirm improved compliance and reduced errors post-standardization.

Conclusions:

• Standardizing dosing units for dose-adjustable intravenous infusions enhances medication administration consistency.
• This standardization significantly decreases the potential for dosing errors with critical medications.
• The initiative supports safer medication practices in academic medical centers.