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Standardisation of intravenous infusion therapy for paediatrics: big challenges for the little patients
Irene Taladriz-Sender1, Silvia Manrique-Rodríguez2, Cecilia M Fernández-Llamazares1
1Pharmacy, Hospital General Universitario Gregorio Maranon, Madrid, Madrid, Spain.
Insights
Standardizing intravenous drug dilutions in pediatric and neonatal care is crucial for patient safety. This study successfully achieved consensus on drug concentrations, paving the way for unified clinical practices.
Area of Science:
- Pediatric Pharmacology
- Clinical Pharmacy Practice
- Patient Safety Research
Background:
- Intravenous drug administration in pediatrics carries inherent risks.
- Variability in intravenous medication preparation and handling increases the risk of adverse events in children.
- Standardization of intravenous drug management is advocated globally to enhance pediatric patient safety.
Purpose of the Study:
- To establish standardized dilutions for commonly used intravenous drugs in Spanish pediatric and neonatal patients.
- To reduce medication errors and improve safety in pediatric and neonatal intensive care settings.
Main Methods:
- A modified Delphi procedure involving two rounds was employed for consensus building.
- The consensus focused on intravenous drugs administered via continuous or intermittent infusion to hospitalized pediatric and critically ill patients.
- Expert consensus was sought on drug concentrations for both pediatric and neonatal populations.
Main Results:
- For pediatric patients, consensus was reached on 160 out of 192 (72.7%) proposed concentrations for 101 drugs.
- For neonatal patients, consensus was achieved on 120 out of 189 (49.2%) proposed concentrations for 80 drugs.
- High consensus rates were achieved for the drugs included in the final standardization proposal.
Conclusions:
- Standardization of intravenous drug dilutions is a feasible and achievable goal for healthcare institutions.
- The developed consensus provides a foundation for unifying pediatric clinical practice across different centers.
- Implementing standardized protocols can significantly contribute to improving the safety of intravenous medication use in children.
Background:
Worldwide organisations advocate standardising the management of intravenous drugs as an essential strategy to increase safety in paediatric healthcare settings. Intravenous administration is a route associated with some potential complications. Many adverse events are related to the use of intravenous medications, and the great variability in their handling and preparation represents an added risk that jeopardises the safety of children.
Purpose:
To standardise the dilutions of intravenous drugs most commonly administered to Spanish hospitalised paediatric and neonatal patients.
Methods:
The process leading to the standardisation of concentrations was undertaken following a two-round modified Delphi procedure. The consensus included the most common drugs administered by continuous or intermittent intravenous infusion to hospitalised and/or critically ill paediatric patients.
Results:
For paediatric patients, the proposal included a total of 102 drugs (45 continuous infusion and 59 intermittent infusion), with 192 concentrations to be standardised. The final consensus included 101 drugs (99%), of which 44 were continuous infusion and 59 intermittent infusion; 160 concentrations were standardised (72.7%). For neonates, the initial proposal included 80 drugs (38 continuous infusion and 43 intermittent infusion), with 189 concentrations to be standardised. The final consensus included 80 drugs (100%), of which 38 were continuous infusion and 43 were intermittent infusion; 120 concentrations were standardised (49.2%).
Conclusions:
This proposal showed that standardisation is a feasible approach that can be reached by other healthcare institutions. It can be used in other centres and contribute in the future to unifying paediatric clinical practice.
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