Designing and evaluating an automated intravenous dosage medication calculation tool for reducing the time of stat medication administration in a pediatric emergency department

Yara AlGoraini; Nevin Hakeem; Mohammad AlShatarat; Mohammed Abudawass; Amani Azizalrahman; Rafath Rehana; Donabel Laderas; Nina AlCazar; Ibrahim AlHarfi

doi:10.1016/j.heliyon.2020.e04140

Designing and evaluating an automated intravenous dosage medication calculation tool for reducing the time of stat medication administration in a pediatric emergency department

Heliyon. 2020 Jun 4;6(6):e04140. doi: 10.1016/j.heliyon.2020.e04140. eCollection 2020 Jun.

Authors

Yara AlGoraini¹, Nevin Hakeem², Mohammad AlShatarat³, Mohammed Abudawass³, Amani Azizalrahman⁴, Rafath Rehana³, Donabel Laderas³, Nina AlCazar³, Ibrahim AlHarfi⁵

Affiliations

¹ Pediatric Department, King Fahad Medical City, Riyadh, Saudi Arabia.
² Pediatric Pharmacy, Children's Hospital Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia.
³ Registered Nurse, Pediatric Emergency Department, King Fahad Medical City, Riyadh, Saudi Arabia.
⁴ Consultant Pediatric Emergency Department, King Fahad Medical City, Riyadh, Saudi Arabia.
⁵ Consultant Pediatric Intensive Care Unit, King Fahad Medical City, Riyadh, Saudi Arabia.

Abstract

Background: Urgent medications are regularly prescribed using the term "stat", which indicates that the medication should be administered within 30 min after it is ordered. However, many hospitals struggle to reliably administer stat medications within 30 min after they are ordered. This study involved developing and evaluating an automated intravenous dosage medication calculation tool (AIVDMCT) for reducing the time between the order and administration of stat medications to children at a pediatric emergency department (PED) in Saudi Arabia.

Methods: This prospective observational study evaluated data from before (June-December 2016) and after (June-December 2017) the AIVDMCT was implemented for high-risk medications in our PED. Patients were considered eligible if they were <14 years old, weighed <40 kg, and required stat intravenous (IV) medications at the PED of our tertiary care hospital.

Results: Implementation of the AIVDMCT significantly reduce the intervals between the time of order (TO) and the time of preparation (TP) (average time: 8.05 ± 3.42 min) and between the TP and the time of administration (TA) (average time: 3.74 ± 1.70 min). Furthermore, the interval from the TO to the TA was significantly reduced after the AIVDMCT was implemented (average time: 11.79 ± 4.48 min, P < 0.001).

Conclusion: The AIVDMCT was associated with a significant reduction in the interval from the TO to the TA. This increased the proportion of stat medications that were delivered within the 30-min target window.

Keywords: Dose calculation accuracy; Emergency medicine; Health sciences; Intravenous dose; Medication administration errors; Patient safety; Pediatrics; Pediatrics emergency department; Pharmacology; Public health.