Improving Pediatric Outcomes through Intravenous and Oral Medication Standardization
| Autor: | Fred L. Farr, Sabrina Boehme, Kevin B. Jones, Mark MacKay, Jared Cash, Marc Holley |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Decision support system Standardization business.industry Intravenous solutions Product testing Order entry Parenteral nutrition Pediatrics Perinatology and Child Health Medicine Pharmacology (medical) Medical physics Dosing Clinical Investigation business Intensive care medicine |
| Popis: | BACKGROUND Standardization is an invaluable tool to promote safety, improve care, and decrease costs, which ultimately improves outcomes. However, a pediatric setting presents unique challenges with its wide variety of weights, medications, and needs that are distinctly different. Our goal was to develop and implement standards in complex high risk areas that show improved outcomes and safety. PROGRAM DESCRIPTION A computerized prescriber order entry program with decision support for pediatrics was developed for parenteral nutrition prescribing. The program included dosing, calculations, calcium phosphate compatibility checks, automated IV compounder interface, osmolarity route calculation, end product testing verification, aluminum exposure and many other quality improvements. This same electronic order program, interface to sterile compounders, and end product testing was used to standardize and make common non-manufactured intravenous solutions. The drip compounding process was reengineered to include standard concentrations, label changes, and beta-testing of a smart syringe pump with dosing ranges for pediatrics. Common standard oral doses were developed along with standard oral formulations. CONCLUSIONS Total parenteral nutrition (TPN) error rates decreased from 7% to less than 1% and compatibility issues decreased from 36 to 1 per year. Neonatal osteopenia rates decreased from 15% to 2%. Results from end product testing of TPN solutions were within USP standards showing statistical correlation (p |
| Databáze: | OpenAIRE |
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