5%) for morphine sulphate injection. Lack of appreciation
of the overage in morphine ampoules by healthcare professionals, mainly in theatres. Administering infusions to children requires complex dose calculations, infusion rate adjustments and often requires several GDC-0941 mouse manipulations of injectable medicines to obtain the final “ready to use” infusion solution. This system is high risk in terms of administration and consequent serious adverse events.1 Errors in intravenous drug preparations involving the wrong diluent or volume / dose or wrong infusion rate are common.2 The aim of this study was to investigate current practice preparing morphine infusions for nurse/patient-controlled analgesia (N/PCA) in a UK children hospital. Prospective observational study of current practice in preparing morphine N/PCA was carried out over three months (21/05–16/08/13) at one UK children hospital. A pharmacist, researcher observed healthcare professionals (HCPs), nurses and doctors, preparing N/PCA infusions in paediatric theatres and wards. The data collection form included; patient demographics, prescription Dabrafenib in vitro and preparation
process details. Descriptive analysis was performed using stata software. In order to assess the accuracy of the final product of morphine infusion, a sample of 78 used syringes prepared in theatre or on the ward were analysed using by UV-Vis Spectrophotometer (Varian Cary®) by the Trust’s Quality Control (QC) department. Measured concentration was then compared to the
British Pharmacopoeia (BP) acceptable limits for morphine sulphate injection of ±7.5% of the labelled strength (LS), i.e. prescribed dose. This study received Trust Research and Development approval. Ethics approval was not required as data collection was part of a service development to consider the use of standard morphine concentrations for N/PCA. In total 153 individually prepared syringes by HCPs for 128 children [mean age (±SD) 7.5 years ± 5.6; 65.3% male] were observed. Majority of the observed syringes were prepared by doctors in paediatric theatres (64.1%, 98/153), and 35.9% (55/153) were prepared by nurses on the wards. Major differences among HCPs in preparation methods were identified. Mean preparation time for morphine syringes was 7.7 minutes (SD ± 3.2). Syringes prepared by doctors in theatres http://www.selleck.co.jp/products/cobimetinib-gdc-0973-rg7420.html had a mean preparation time of 6.4 minutes (SD ± 2.2) compared to those prepared on wards by nurses (10 minutes, SD ± 3.5), p < 0.001. For 59.2% (58/98) of syringes prepared by doctors in theatre compared to 21.2% (12/55) prepared by nurses on wards, the dose calculation was not checked with a second person, (p < 0.001). Confusion of HCPs about the exact content of the morphine ampoule was identified, mainly in theatres (doctors). Final volume prepared was above the required volume (50 mL) in 33.3% (51/153) preparations [doctors 70.