IV Push Medication Administration: Making Safe Choices; Choosing Best Practice

Abstract

It has been estimated that more than 90% of hospitalized patients receive some form of intravenous (IV) therapy. 1 Baranowski L Presidential address: take ownership. J Intraven Nurs. 1995; 18: 162-164 PubMed Google Scholar , 2 Corrigan A Infusion nursing as a specialty. in: Alexander M Corrigan A Gorski L Hankins J Perucca R Infusion Nursing: An Evidence-based Approach. 3rd ed. Saunders Elsevier, St Louis, MO2010 Google Scholar Errors involving the use of IV medications are more common than once recognized and occur in all phases of the medication use process. These errors can be particularly dangerous, depending on the drug’s properties and the complexity of its therapeutic action. Although IV push medications are clinically advantageous because of their immediate therapeutic effect, they are also challenging because of an immediate bioavailability of the administered drug, a narrow therapeutic dose range, and limitations in reversing systemic effects, all of which can contribute to harm. 3 American Society of Health-System Pharmacists Summit proceedings. Am J Health Syst Pharm. 2008; 65: 2367-2379 Google Scholar , 4 Hicks R Becker S An overview of intravenous-related medication administration errors as reported to MEDMARX®, a national medication error-reporting program. J Infus Nurs. 2006; 29: 20-27 Crossref PubMed Scopus (66) Google Scholar The significant risk for patient injury and death related to IV medication errors is well known. 3 American Society of Health-System Pharmacists Summit proceedings. Am J Health Syst Pharm. 2008; 65: 2367-2379 Google Scholar , 4 Hicks R Becker S An overview of intravenous-related medication administration errors as reported to MEDMARX®, a national medication error-reporting program. J Infus Nurs. 2006; 29: 20-27 Crossref PubMed Scopus (66) Google Scholar , 5 Aspden P Wolcott JA Bootman JL Cronenwett LR Committee on Identifying and Preventing Medication Errors, Board on Health Care Services, Institute of Medicine. Preventing Medication Errors: Quality Chasm Series. National Academy Press, Washington, DC2007 Google Scholar , 6 Flynn EA Barker KN Research on errors in dispensing and medication administration. in: Cohen MR Medication Errors. 2nd ed. American Pharmacists Association, Washington, DC2007: 15-41 Google Scholar , 7 Kaushal R Bates DW Landrigan C et al. Medication errors and adverse drug events in pediatric inpatients. JAMA. 2001; 285: 2114-2120 Crossref PubMed Scopus (1379) Google Scholar , 8 Ross LM Wallace J Paton JY Medication errors in paediatric teaching hospital in the UK: five years operational experience. Arch Dis Child. 2000; 83: 492-497 Crossref PubMed Scopus (262) Google Scholar , 9 Institute for Safe Medication Practices Institute for Safe Medication Practices National Medication Errors Reporting Program Database. Institute for Safe Medication Practices, Horsham, PA2015 Google Scholar The Institute for Safe Medication Practices (ISMP) has received and published numerous IV push–related error reports involving patient injury obtained through its National Medication Errors Reporting Program. 9 Institute for Safe Medication Practices Institute for Safe Medication Practices National Medication Errors Reporting Program Database. Institute for Safe Medication Practices, Horsham, PA2015 Google Scholar Susan Paparella, Member, Bux-Mont Chapter, is Vice President at the Institute for Safe Medication Practices (ISMP 1ISMP is a nonprofit organization that works closely with health care practitioners, consumers, hospitals, regulatory agencies, and professional organizations to educate caregivers about preventing medication errors. ISMP is the premier international resource on safe medication practices in health care institutions. If you would like to report medication errors to help others, E-mail us at: [email protected] or call (800)FAIL-SAF(e). This Medication Error Reporting Program keeps information confidential and secure. We will include only the level of detail that the reporter wishes in our publications.), Horsham, PA, and a member of the Advisory Committee for the Institute for Quality, Safety, and Injury Prevention.1ISMP is a nonprofit organization that works closely with health care practitioners, consumers, hospitals, regulatory agencies, and professional organizations to educate caregivers about preventing medication errors. ISMP is the premier international resource on safe medication practices in health care institutions. If you would like to report medication errors to help others, E-mail us at: [email protected] or call (800)FAIL-SAF(e). This Medication Error Reporting Program keeps information confidential and secure. We will include only the level of detail that the reporter wishes in our publications.) Michelle Mandrack is Director of Consulting Services, Institute for Safe Medication Practices, Horsham, PA.