R. M. Adapa, V Mani, L. J. Murray, B. A. Degnan, A Ercole, B Cadman, C

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Presentation transcript:

Errors during the preparation of drug infusions: a randomized controlled trial R.M. Adapa, V Mani, L.J. Murray, B.A. Degnan, A Ercole, B Cadman, C.E. Williams, A.K. Gupta, D.W. Wheeler British Journal of Anaesthesia Volume 109, Issue 5, Pages 729-734 (November 2012) DOI: 10.1093/bja/aes257 Copyright © 2012 The Author(s) Terms and Conditions

Fig 1 (a) The median time (s), indicated by the bars, taken to ready a pre-filled norepinephrine syringe for administration was 157 s (IQR 107–195 s) compared with 260 s (IQR 211–334 s) for the group of nurses making the infusion de novo (P<0.001). (b) For epinephrine, which required more ampoules to be opened, the pre-filled syringes were readied in a median time of 147 s (IQR 107–180 s) while de novo preparation took 278 s (IQR 235–311 s) (P<0.001). The adjusted mean time from request to administration was 106 s (95% CI 73–140 s) greater for all infusions made from ampoules rather than pre-filled syringes. British Journal of Anaesthesia 2012 109, 729-734DOI: (10.1093/bja/aes257) Copyright © 2012 The Author(s) Terms and Conditions

Fig 2 (a) Concentrations of norepinephrine infusions. Bars indicate a median concentration of 88.5% (IQR 75.9–106.3%) of that expected for de novo syringes, vs 102.9% (IQR 97.9–109.4%) for those pre-filled by physicians, 102.6% (IQR 96.8–108.8%) for those pre-filled in pharmacy, and 101.0% (IQR 98.9–106.0%) for those pre-filled by industry. The dotted line at 100% indicates the correct concentration; the shaded box represents ±10%, the USP standard.14 Statistically significant differences between groups, on the basis of Dunn’s multiple comparison test, are shown. (b) Concentrations of epinephrine infusions. Bars indicate a median concentration of 91.4% (IQR 70.8–96.4%) of that expected for de novo syringes, vs 96.4% (IQR 86.6–100.6%) for those pre-filled by physicians, 100.3% (IQR 93.0–105.1%) for those pre-filled in pharmacy, and 101.2% (IQR 97.4–108.4%) for those pre-filled by industry; 100% was the correct concentration. Statistically significant differences between the groups, on the basis of Dunn’s multiple comparison test, are shown. British Journal of Anaesthesia 2012 109, 729-734DOI: (10.1093/bja/aes257) Copyright © 2012 The Author(s) Terms and Conditions