Decreasing errors in pediatric continuous intravenous infusions

Christoph U. Lehmann, George R Kim, Renmeet Gujral, Michael A. Veltri, John S. Clark, Marlene R. Miller

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation. Design: Data on ordering error frequency and typology were collected before and after implementation of an online infusion ordering system. Data on pharmacy preparation errors of infusions were collected. Setting: A children's hospital at an academic medical center. Patients: None. Data were abstracted from infusion orders. Interventions: Introduction of a voluntary-use Web-based calculator into infusion ordering workflow. Observation only. Main Outcome measures: Number and type of errors in handwritten and calculator-generated orders. Number and type of errors in pharmacy infusion preparation. Results: Before calculator deployment, 129 sequential handwritten infusion orders were collected over 5 weeks. After deployment, of 162 sequential infusion orders, 88% (142) were calculator-generated. Calculator-generated infusion orders contained 83% fewer (p <.001) orders containing one or more errors than handwritten orders. Calculator-generated orders contained no high-risk errors (incorrect decimal, dose, or unit of measure) when compared with handwritten orders and were associated with fewer pharmacy interventions. In 118 sequential pharmacy infusion preparations over 4 wks, there were no errors observed. Conclusion: A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.

Original languageEnglish (US)
Pages (from-to)225-230
Number of pages6
JournalPediatric Critical Care Medicine
Volume7
Issue number3
DOIs
StatePublished - May 2006

Fingerprint

Intravenous Infusions
Pediatrics
Workflow
Observation
Outcome Assessment (Health Care)

Keywords

  • Computer-assisted
  • Decision support systems
  • Drug therapy
  • Infusions
  • Medication errors, prevention and control

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Decreasing errors in pediatric continuous intravenous infusions. / Lehmann, Christoph U.; Kim, George R; Gujral, Renmeet; Veltri, Michael A.; Clark, John S.; Miller, Marlene R.

In: Pediatric Critical Care Medicine, Vol. 7, No. 3, 05.2006, p. 225-230.

Research output: Contribution to journalArticle

Lehmann, Christoph U. ; Kim, George R ; Gujral, Renmeet ; Veltri, Michael A. ; Clark, John S. ; Miller, Marlene R. / Decreasing errors in pediatric continuous intravenous infusions. In: Pediatric Critical Care Medicine. 2006 ; Vol. 7, No. 3. pp. 225-230.
@article{13b2d6e6bc2148dda1eaf7a3be5a41c3,
title = "Decreasing errors in pediatric continuous intravenous infusions",
abstract = "Objective: To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation. Design: Data on ordering error frequency and typology were collected before and after implementation of an online infusion ordering system. Data on pharmacy preparation errors of infusions were collected. Setting: A children's hospital at an academic medical center. Patients: None. Data were abstracted from infusion orders. Interventions: Introduction of a voluntary-use Web-based calculator into infusion ordering workflow. Observation only. Main Outcome measures: Number and type of errors in handwritten and calculator-generated orders. Number and type of errors in pharmacy infusion preparation. Results: Before calculator deployment, 129 sequential handwritten infusion orders were collected over 5 weeks. After deployment, of 162 sequential infusion orders, 88{\%} (142) were calculator-generated. Calculator-generated infusion orders contained 83{\%} fewer (p <.001) orders containing one or more errors than handwritten orders. Calculator-generated orders contained no high-risk errors (incorrect decimal, dose, or unit of measure) when compared with handwritten orders and were associated with fewer pharmacy interventions. In 118 sequential pharmacy infusion preparations over 4 wks, there were no errors observed. Conclusion: A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.",
keywords = "Computer-assisted, Decision support systems, Drug therapy, Infusions, Medication errors, prevention and control",
author = "Lehmann, {Christoph U.} and Kim, {George R} and Renmeet Gujral and Veltri, {Michael A.} and Clark, {John S.} and Miller, {Marlene R.}",
year = "2006",
month = "5",
doi = "10.1097/01.PCC.0000216415.12120.FF",
language = "English (US)",
volume = "7",
pages = "225--230",
journal = "Pediatric Critical Care Medicine",
issn = "1529-7535",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Decreasing errors in pediatric continuous intravenous infusions

AU - Lehmann, Christoph U.

AU - Kim, George R

AU - Gujral, Renmeet

AU - Veltri, Michael A.

AU - Clark, John S.

AU - Miller, Marlene R.

PY - 2006/5

Y1 - 2006/5

N2 - Objective: To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation. Design: Data on ordering error frequency and typology were collected before and after implementation of an online infusion ordering system. Data on pharmacy preparation errors of infusions were collected. Setting: A children's hospital at an academic medical center. Patients: None. Data were abstracted from infusion orders. Interventions: Introduction of a voluntary-use Web-based calculator into infusion ordering workflow. Observation only. Main Outcome measures: Number and type of errors in handwritten and calculator-generated orders. Number and type of errors in pharmacy infusion preparation. Results: Before calculator deployment, 129 sequential handwritten infusion orders were collected over 5 weeks. After deployment, of 162 sequential infusion orders, 88% (142) were calculator-generated. Calculator-generated infusion orders contained 83% fewer (p <.001) orders containing one or more errors than handwritten orders. Calculator-generated orders contained no high-risk errors (incorrect decimal, dose, or unit of measure) when compared with handwritten orders and were associated with fewer pharmacy interventions. In 118 sequential pharmacy infusion preparations over 4 wks, there were no errors observed. Conclusion: A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.

AB - Objective: To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation. Design: Data on ordering error frequency and typology were collected before and after implementation of an online infusion ordering system. Data on pharmacy preparation errors of infusions were collected. Setting: A children's hospital at an academic medical center. Patients: None. Data were abstracted from infusion orders. Interventions: Introduction of a voluntary-use Web-based calculator into infusion ordering workflow. Observation only. Main Outcome measures: Number and type of errors in handwritten and calculator-generated orders. Number and type of errors in pharmacy infusion preparation. Results: Before calculator deployment, 129 sequential handwritten infusion orders were collected over 5 weeks. After deployment, of 162 sequential infusion orders, 88% (142) were calculator-generated. Calculator-generated infusion orders contained 83% fewer (p <.001) orders containing one or more errors than handwritten orders. Calculator-generated orders contained no high-risk errors (incorrect decimal, dose, or unit of measure) when compared with handwritten orders and were associated with fewer pharmacy interventions. In 118 sequential pharmacy infusion preparations over 4 wks, there were no errors observed. Conclusion: A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.

KW - Computer-assisted

KW - Decision support systems

KW - Drug therapy

KW - Infusions

KW - Medication errors, prevention and control

UR - http://www.scopus.com/inward/record.url?scp=33646861388&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646861388&partnerID=8YFLogxK

U2 - 10.1097/01.PCC.0000216415.12120.FF

DO - 10.1097/01.PCC.0000216415.12120.FF

M3 - Article

C2 - 16575355

AN - SCOPUS:33646861388

VL - 7

SP - 225

EP - 230

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

SN - 1529-7535

IS - 3

ER -