P15 Feasibility of the introduction of aseptically prepared dose banded antimicrobials in a paediatric hospital
Notice bibliographique
Résumé
Aim In 2007 the National Patient Safety Agency issued an alert entitled ‘Safer Use of Injectable Medicines’. In response to this alert a number of hospitals have set up Centralised Intravenous Additive Services (CIVAS) to provide ready to use syringes for commonly prescribed intravenous (IV) medications to the wards. It offers a number of advantages including: saving nursing time, reducing risk of calculation and manipulation errors, improving infection prevention and control and leading to potential cost saving (vial sharing). A recent audit in our hospital identified 20% of wastage of ready to use syringes associated with significant cost. One way in which to address the issue is produce batches of ready to use syringes of dose banded antimicrobial. Also, the Peadiatric Sepsis 6 Initiative states that intravenous antibiotics should be given to the patients within the hour. Dose-banded antimicrobial preparation could also assist the paediatric emergency department to reduce the patient’s wait. The aims of the study was to review the current practice of other paedatric hospitals in order to analyze the feasibility of introducing batch production of dose-banded antimicrobials. Method We conducted a 20-question survey sent from the 18th of February until the 7th of April 2021 to the Neonatal and Paediatric Pharmacy Group (NPPG), French Society of Clinical Pharmacy (SFPC), European Association of Hospital Pharmacy (EAHP) and other hospital pharmacists from Belgium and Switzerland. Results Forty-eight pharmacists from 44 paediatric hospitals and 8 different country participated to the survey. Seventeen (36%) were from the United Kingdom, n=16 (32.7%) from France, n=7 (14.3%) from Belgium, n=4 (8.2%) from Switzerland, n=1 (2%) from Canada, n=1 (2%) from Finland, n=1 (2%) from Ireland and n=1 (2%) from Russia. Almost all the participants have heard about dose banding before (n=45; 94%). Only n=13 (31%) hospitals prescribed medications with dose bands such as IV chemotherapies (n=27; 64.3%), antimicrobials (n=9; 21.4%) and other type of drugs (n=6; 14.3%). The dose banded antimicrobials were cefotaxime, ceftriaxone, piperacillin/tazobactam and benzylpenicillin. Almost all of the participants agreed that it could reduce prescription errors (n=37; 77.1%), save nursing time (n=37; 77.1%) or reduce wastage by reassigning the syringe to another patient (n=32; 66.7%). On the other hand, n=13 (27.1%) participants thought dose banding can expose to risks of drug inefficacy or toxicity by not giving the exact dose (milligram-per-weight) and n=8 (16.7%) thought it can increase wastage (because of the batch production and the expiry date). Only 13 hospitals (29%) prepared some antimicrobial in the centralized aseptic unit with milligram-per-weight doses. Conclusion Some paediatric hospitals have experienced dose banding for IV antimicrobials such as cefotaxime, ceftriaxone, piperacillin/tazobactam and benzylpenicillin. The participants of the survey thought that it was very attractive in order to reduce wastage and the prescription errors. On the other hand, there was no paediatric hospitals currently producing batches of IV antimicrobials in the CIVAS. Introducing batches of dose banded antimicrobials will needs further studies about time and cost saving as well as stability of some IV antimicrobials syringes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».