Children's Health Ireland, Dublin 2, D12 N512, Ireland.
Royal College of Surgeons in Ireland, Dublin 2, D02 YN77, Ireland.
Int J Clin Pharm. 2024 Feb;46(1):4-13. doi: 10.1007/s11096-023-01652-3. Epub 2023 Nov 16.
Standard concentration infusions and 'smart-pumps' are recognised as best practice in the paediatric setting. Implementation rates in European hospitals remain low. Children's Health Ireland (CHI) developed a paediatric 'smart-pump' drug library using standardised concentrations. At time of development, other Irish hospitals continued to use traditional pumps and weight-based paediatric infusions.
To expand best paediatric infusion practices by nationalising use of the CHI drug library.
Tertiary paediatric, maternity and general acute hospitals, and associated transport services in Ireland.
The CHI drug library was first developed for paediatric intensive care and then adapted over a 10-year period for use in emergency departments, general paediatric wards, neonatal units, adult intensive care and transport services. The original library (42 drug lines, 1 'care-unit') was substantially expanded (223 drug lines, 6 'care-units'). A neonatal sub-library was created.
Executive support, dedicated resources and governance structures were secured. Implementation and training packages were developed. Implementation has occurred across CHI, in paediatric and neonatal transport services, 58% (n = 11) of neonatal units, and 23% (n = 6) of paediatric sites.
A before and after study demonstrated significant reductions in infusion prescribing errors (29.0% versus 8.4%, p < 0.001). Direct observation of infusions (n = 1023) found high compliance rates (98.9%) and low programming errors (1.6%). 100% of nurses (n = 132) surveyed 9 months after general ward implementation considered the drug library had enhanced patient safety.
Strategic planning and collaboration can standardise infusion practices. The CHI drug library has been approved as a National Standard of Care, with implementation continuing.
标准浓度输注和“智能输液泵”在儿科环境中被认为是最佳实践。欧洲医院的实施率仍然很低。爱尔兰儿童健康（CHI）使用标准化浓度开发了儿科“智能输液泵”药物库。在开发时，其他爱尔兰医院继续使用传统的输液泵和基于体重的儿科输液。
通过在全国范围内使用 CHI 药物库来扩大最佳儿科输液实践。
爱尔兰的三级儿科、产科和普通急症医院，以及相关的运输服务。
CHI 药物库最初是为儿科重症监护开发的，然后在 10 年内适应于急诊部门、普通儿科病房、新生儿病房、成人重症监护和运输服务。原始库（42 条药物线，1 个“护理单元”）得到了大幅扩展（223 条药物线，6 个“护理单元”）。创建了一个新生儿子库。
获得了执行支持、专用资源和治理结构。开发了实施和培训包。CHI 在儿科和新生儿运输服务、58%（n=11）的新生儿病房和 23%（n=6）的儿科病房中实施了该库。
一项前后对照研究表明，输液处方错误显著减少（29.0%对 8.4%，p<0.001）。对 1023 次输液的直接观察发现，合规率很高（98.9%），编程错误很低（1.6%）。在一般病房实施后 9 个月接受调查的 100%护士（n=132）认为药物库增强了患者安全。
战略规划和协作可以使输液实践标准化。CHI 药物库已被批准为国家护理标准，实施工作仍在继续。
