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A Multi-hospital Before-After Observational Study Using a Point-Prevalence Approach with an Infusion Safety

Kumiko O Schnock1,2, Patricia C Dykes3,4, Jennifer Albert5

  • 1Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, OBC-3, Boston, MA, 02120-1613, USA. kschnock@bwh.harvard.edu.

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A new safety intervention bundle reduced overall and medication errors in smart infusion pump use. However, potentially harmful errors did not change, indicating a need for further research to improve infusion safety.

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Area of Science:

  • Healthcare quality improvement
  • Patient safety research
  • Medication administration technology

Background:

  • High rates of errors in intravenous medication administration via smart infusion pumps were previously identified.
  • A comprehensive infusion safety intervention bundle was developed to address these identified errors.

Purpose of the Study:

  • To evaluate the preliminary effects of an infusion safety intervention bundle on medication administration errors.
  • To measure changes in overall errors, medication errors, and potentially harmful errors post-intervention.

Main Methods:

  • A before-after observational study with a prospective point-prevalence approach was conducted across nine hospitals.
  • Data collected included 972 medication administrations (pre-intervention) and 1059 (post-intervention) across 418 and 422 patients, respectively.
  • Primary outcomes were overall and medication error rates; secondary outcome was potentially harmful error rates.

Main Results:

  • The overall error rate decreased significantly from 146 to 123 per 100 administrations (p < 0.0001).
  • Medication error rates also saw a significant reduction from 39 to 29 per 100 administrations (p = 0.001).
  • No significant change was observed in potentially harmful error rates (0.5 to 0.8 per 100 administrations, p = 0.37).

Conclusions:

  • The intervention bundle successfully reduced overall and medication error rates, demonstrating effectiveness in improving infusion safety.
  • Certain intervention components, like those targeting labeling errors, were effective, but overall impact varied.
  • Further research is necessary to identify optimal strategies for reducing remaining errors, particularly potentially harmful ones.