Development and implementation of a pediatric/neonatal i.v. syringe pump delivery system

The potential adverse effects on the neonatal/pediatric population of administering concentrated intravenous medications are a concern. After an adult minibag was successfully converted to a syringe pump system, a similar system for neonates and children was developed. Additional factors considered with this conversion included: osmolarity, fluid volumes, and i.v. administration procedures. Charts that provided information on appropriate final concentrations of commonly used drugs were developed for nursing and pharmacy staffs. Inservice education was given to ensure understanding and compliance with the charts as well as the procedures developed for this delivery system (such as i.v. line setup, flushing procedures, and tubing changes). When this system was implemented, aminoglycosides were administered in a uniform manner. Previously, each area had its own method of aminoglycoside administration, which was not conducive to reliable therapeutic drug monitoring. Significant improvements in patient care, drug waste, and therapeutic drug monitoring resulted from using the pediatric syringe pump delivery system.