Background The prescription, preparation and use of parenteral solutions are complex processes composed of many steps, during which mistakes can occur. However, by means of the National Patient Safety Alert 20 (NPSA 20), a risk evaluation of continuous injection/-infusion solutions can be performed.
Purpose To evaluate the risks associated with the intravenous drug treatment of intensive care unit patients at the University Medical Center Mainz. We planned to use the results to identify high-risk products and implement measures to reduce potential risks.
Materials and Methods The NPSA 20 defines eight different risk factors for the evaluation of overall risk. The risk evaluation was conducted for 78 continuous injection/-infusion solutions used in intensive care unit patients. These parenteral solutions are used in standardised concentrations; 16 of them were prepared as ready-to-use products in the hospital pharmacy. The potential risks of these 16 preparations were compared with the risks of those not prepared centrally in the hospital pharmacy department.
Results The risk evaluation of the 78 continuous injection/-infusion solutions revealed that most of the standardised 78 solutions were moderate-risk products (68%). Other solutions were classified as low-risk products (26%). Only 6% of the solutions were high-risk products. The favourable results of the risk analysis can be explained by the hospital-wide use of standardised concentrations. Doses are adjusted by using the infusion rate. For a number of products (12%) the risk category was downgraded from moderate to low, since ready-to-use products were prepared in the hospital pharmacy department.
Conclusions Out of 78 drug products administered as continuous injection/-infusion solutions to intensive care unit patients only 6% were categorised as high-risk. This favourable result is explained the use of standardised concentrations and preparation of ready-to-use products in the pharmacy department.
No conflict of interest.
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