Implementation of iv infusion and admixture guidelines by a clinical pharmacist to reduce medication administration errors in a tertiary care hospital

Abstract

Pharm. D students while on internship in a tertiary care hospital in India noticed that hospital currently has no IV-administration protocols. For example, when Doctor wrote an Amphotericin B 50mg IV once daily – there were no accompanying instructions on the nature of diluent to be used, how much of it should be used and what should be the rate of infusion. The nurses receiving the above order are not aware of any protocols for IV administration. Interns learnt that nurses diluted all drugs in NS and infused over 30 to 60 minutes.

Student pharmacists identified this as potential area for intervention that can lead to better therapeutic outcomes for the patients. The interns made a list of all the IV antibiotic commonly prescribed in that hospital and developed protocols for choosing appropriate dilution fluid, ratio of dilution and rate of infusion. These protocols were displayed in the nursing station and wards and nurses, duty doctors were educated regarding the same.

Inclusion of this protocol produced signficant reduction in administration errors.