Intravenous infusion administration: A comparative study of practices and errors between the United States and England and their implications for patient safety

Summary

Blandford et al. investigated the similarities and differences in practices and error types involving intravenous medication administration in the US and UK, published in the journal Drug Safety.

Content

Intravenous medication administration is widely reported to be error prone. Technologies such as smart pumps have been introduced with a view to reducing these errors. The research groups, from the UK and US, drew on findings of separate point prevalence studies conducted across hospitals in each country. They compared what was being administered at the time of observation with the prescription and relevant policies, errors were classified by type and severity, and proportions of infusions featuring each error type were calculated. They also reviewed what adaptations to the US protocol were needed for the UK.

Although US sites made greater use of smart infusion devices, and had more precisely defined requirements around infusion device use, patterns of errors were similar. Differences among clinical contexts within each country were as marked as differences across countries.

They concluded that infusion administration is a complex adaptive system with multiple interacting agents (professionals, patients, software systems, etc.) that respond in rich ways to their environments; safety depends on complex, interrelated factors.