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Oct 15, 2018

7th Congress of the European Academy of Paediatric Societies

DIRECT OBSERVATIONAL STUDY OF INFUSION ERRORS ASSOCIATED WITH SMART-PUMP TECHNOLOGY IN PAEDIATRIC INTENSIVE CARE

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medication errors

smart-pump technology

standard concentration infusions

paediatric intensive care

Abstract

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Keywords

medication errors

smart-pump technology

standard concentration infusions

paediatric intensive care

Abstract

Background and Aims: Smart-pump technology and standardised concentration infusions (SCIs) are advocated to reduce infusion errors in the high-risk paediatric intensive care unit (PICU) setting. We implemented a smart-pump SCI library, from which infusion data is auto-transferred to the PICU clinical information management system. This study aims to determine the frequency, severity and stage of smart-pump infusion errors. Methods: All infusions programmed at each bedside were directly observed, and compared against medication orders and auto-populated infusion data. Identified deviations were categorised, using pre-defined definitions, as medication errors or discrepancies. 5 opportunities for error (OEs) were identified: programming, administration, documentation, assignment, data transfer. Error rates were calculated as no. of infusions with errors, and errors per OEs. Multi-disciplinary consensus and grading processes were utilised. Results: 1023 infusions for 175 patients were directly observed on 27 days between February and September 2017. 74% of patients were under 1 year, 32% under 1 month. 96.5% of infusions were via the drug library, 72% were SCIs, 13% maintenance fluids, and 10% nutrition. Compliance with the drug library was 98.9%. 55 infusions had ≥ 1 error (5.4%); a further 67 (6.3%) had ≥ 1 discrepancy. A total of 72 errors (1.4%), and 107 discrepancies (2.1%) were observed out of 4997 OEs. Documentation errors were most common; programming errors were rare (0.32%). Errors were minor, with just one requiring minimal intervention to prevent harm. Conclusion: These error rates are low compared to similar studies, demonstrating the benefits of smart-pumps and auto-populated infusion data in the paediatric intensive care setting.

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© Copyright 2019 Morressier GmbH.
All rights reserved.