Antimicrobial infusion practices within intensive care units: Carbapenem infusion preparation and administration...

Area of Science:

• Pharmacology
• Infectious Diseases
• Nursing Practice

Background:

• Intermittent carbapenem infusions are critical in intensive care units (ICUs).
• Variability in nurse preparation and administration practices can impact therapeutic efficacy.
• Understanding these practices is crucial for optimizing antibiotic delivery.

Purpose of the Study:

• To describe and analyze nurse preparation and administration of intermittent carbapenem infusions.
• To identify discrepancies in infusion timing, duration, and drug delivery.
• To assess drug loss during the reconstitution and administration process.

Main Methods:

• Observational study in three general ICUs.
• Documented carbapenem infusion process for adult patients.
• Measured infusion timing, duration, and performed volumetric analysis of drug loss.

Main Results:

• 223 carbapenem infusions were observed; only 60% complied with infusion duration guidelines.
• Significant drug losses occurred during preparation (vials, syringes) and administration (infusion bags, lines).
• No consistent flushing practice was observed post-infusion.

Conclusions:

• Incorrect administration practices lead to variable infusion durations and under-dosing.
• Under-dosing contributes to antibiotic resistance selection pressure.
• Standardized protocols for intermittent antimicrobial infusions, including line flushing, are essential.