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Nursing perceptions of the preparation of intravenous medicines in paediatric intensive care
  1. L Hughes,
  2. M Johnstone,
  3. A Sutherland
  1. Royal Hospital for Sick Children, Glasgow, UK

Abstract

  1. To evaluate and compare nursing perceptions around intravenous preparation with the reality of intravenous preparation in a 24-bedded Paediatric Critical Care Unit.

  2. To assess the attitudes of nursing staff towards pharmacy staff potentially getting involved in intravenous preparation in the near-patient area.

  3. To identify those intravenous preparations that nursing staff would prioritise for pharmacy preparation and compare these with a risk-assessment based prioritisation.

Methods Anonymised questionnaires and direct observation of 150 intravenous preparations on the ward.

Results Questionnaire response rate: 33% (130 distributed, 45 returned).

Nursing staff have no strong opinion on the preparation of intravenous medicines in the ward environment (mean 4.6/10, median 5.5) which indicates broad acceptance of the role as part of the job, but would suggest a willingness to accept additional support. The majority of nurses estimated each intravenous preparation to be around 5 min (37/44) when in reality it takes an average of 18.9 min to prepare one intravenous dose (range: 5–55 min, median: 15 min). Nursing staff suggest that they would like pharmacy staff to prepare reconstituted antibiotics (18/45) and continuous infusions (20/45) A risk assessment of intravenous drugs on Paediatric Intensive Care Unit (PICU) would lead pharmacy to prioritise continuously infused medicines (eg, inotropes).

Conclusion Nursing staff underestimate how much time is spent preparing intravenous medicines.

They acknowledge that there are risks inherent in such processes in a modern PICU.

They would accept pharmacy support in

  • preparation of intravenous doses

  • training nurses for intravenous preparation.

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