Introduction Calculating drug infusions in neonatal unit for sick infants can be challenging, unnerving and time consuming, especially in a neonatal emergency, and especially for junior medical and nursing staff. If done incorrectly, it can lead to untoward side effects or lack of desired effect.
Our trust contains a level 3 and a level 1 unit. In our level 1 unit- investigation of two clinical incidents revealed undue delay in prescription and preparation of the above infusions in the crisis event. In our level 3 unit, there were drug errors due to heavy workload related to the number and complexity of patients.
Aims and Methods We designed a microsoft excel based neonatal drug infusion calculator (NDIC) for key infusions used in neonatal emergencies. Once patient’s weight was entered, NDIC calculated the amount and volume of drug to be drawn up and the volume and nature of diluent to provide the required infusion. The sheet containing calculated drug infusions (dopamine, dobutamine, adrenaline, noradrenaline, vecuronium, and prostin) could then be printed off and signed by the medical prescriber and administering nurse and the printed copy stapled to the actual drug chart as a supplementary chart. We then performed a user-survey and time analysis one year after its implementation to evaluate its impact.
Results We found that it took between 1.08–5.41 min to manually prescribe various infusions as compared to 37.8 s-2.22 min with NDIC to complete a prescription. The major delay in manual prescription was during checking the formulary. In the survey, prescribers found NDIC to be useful and time saving. They felt that it makes prescribing complex and scary drugs very easy. An inexperienced prescriber said, she wouldn’t know what to do without NDIC. Nurses found it very efficient and easy to use. The staff in level 1 unit found it most useful due to being inexperienced prescribers and it enabled them to accomplish other tasks quicker.
Conclusion Infusion calculators are user friendly and time-efficient and may reduce drug errors until e-prescribing becomes universal.
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