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Variability in the concentrations of intravenous drug infusions prepared in a critical care unit.

Abstract：

OBJECTIVE:To quantify the variability in the concentration of drug infusions prepared on an intensive care unit and establish whether there was a relationship between the quality of syringe labeling and drug preparation. DESIGN:Audit carried out over 3 weeks in May 2006 and completed in May 2007. SETTING:The adult neurosciences critical care unit of a UK university teaching hospital. INTERVENTIONS:Daily collections of discarded syringes containing midazolam, insulin, norepinephrine, dopamine, potassium or magnesium. MEASUREMENTS AND RESULTS:Residual solutions in the syringes were sampled and the concentrations measured. Syringe labels were inspected and awarded a score for labeling quality based on an 11-point scale. A total of 149 syringes were analyzed. Six of the magnesium syringes contained 4-5 times too much Mg(2+), presumably because of confusion about converting millimoles to grams. The majority of the other infusions differed from the expected concentration by more than 10%. Magnesium infusions were least likely to be properly labeled (p= 0.012), and there was a positive correlation between quality of syringe labeling and drug preparation (p=0.002). After the introduction of a new electrolyte prescription chart, magnesium and potassium preparation significantly improved but there was still substantial variability. CONCLUSIONS:These findings present a strong argument for the use of pre-prepared syringes or standardized drug preparation and labeling systems. They also highlight once again the difficulties healthcare professionals encounter when dealing with different ways of expressing drug concentrations.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Wheeler DW,Degnan BA,Sehmi JS,Burnstein RM,Menon DK,Gupta AK

doi

10.1007/s00134-008-1113-9

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

1441-7

issue

8

eissn

0342-4642

issn

1432-1238

journal_volume

34

pub_type

杂志文章

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