80% of patients in the hospital will receive intravenous therapy at one point in their hospital stay. Intravenous therapy may include medication, nutrition, fluids or blood components and may be given either through a peripheral (small veins and arteries) or central (major arteries) line. Intravenous therapy brings a lot of benefits and provides an easy means of delivering essential medications and fluids, however, certain complications can arise that contributes to the morbidity and even mortality of patients.
As the focus nowadays is the provision of patient safety, several studies have been conducted regarding the Intravenous administration of drugs as seen below. Medication errors: the human factor By Edward Etchells, David Juurlink, and Wendy Levinson, MD. CMAJ. 2008 January 1; 178(1): 63–64. In this study, 118 health care professionals prepared morphine infusions under a simulated environment. The method utilized by the researchers was direct observation of participants. Chromatography was utilized to achieve the measurement of the concentration of morphine in each infusion prepared by the participant.
The researchers reported that 34. 7 percent of the infusions prepared have a 10% deviation from the intended concentration. Furthermore, since the infusion of morphine requires drug-volume calculations, it was found out that 3% of the participants had 2-fold errors in calculation while 1. 2% had 10-fold errors in calculating for the infusion. As such, findings of the study include high rates of error in the preparation of intravenous medications and that these errors are very common.
The researchers propose that simplifying the steps and standardization may decrease the occurrence of errors and promote patient safety. Factors predictive of intravenous fluid administration errors in Australian surgical care wards By Han PY, Coombes ID, Green B. Qual Saf Health Care. 2005 Jun;14(3):179-84. The intravenous administration of fluids remains as a major factor in clinical care. Errors in administration of these may be detrimental to the patient and may serve to increase the costs associated with healthcare.
The objective of the study includes the establishment of the prevalence of errors in the administration of intravenous medication, including continuous IV infusions as well as the identification of factors and variables that may cause these errors. Another objective is to quantify the likelihood of these errors to occur by utilizing a logistic regression model during data analysis. The study was conducted on three surgical wards at on hospital wherein the participants receive continuous intravenous infusions of IV fluids.
A direct observational approach was utilized to determine the medication errors and the variable that contribute to these errors and were duly documented. Results of the study include an 18% occurrence of error in the medication administration, the most common of which is wrong rate of administration. It was also found out that the chances of an error to occur are increased in the absence of a device for intravenous infusion control and in long durations of intravenous infusions. Researchers propose that intravenous infusion control devices as well as regular checks of the administration rates could reduce the occurrence of errors.