Good Clinical Practice Guidance for Line Materials, Filtration, and Light Protection in Intravenous Medication Administration: Modified Delphi Consensus Study
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Notice bibliographique
Résumé
<sec> <title>BACKGROUND</title> There is an unmet need for reliable medication stability information to avoid suboptimal administration of intravenous medications, which may lead to reduced efficacy of therapy and potential patient harm through medication degradation or incompatibilities that cause vascular access issues. </sec> <sec> <title>OBJECTIVE</title> This study aimed to develop evidence-informed guidance for pharmacists and nurses on the use of administration line materials, in-line filtration, and light protection during storage and intravenous administration of medications commonly used in critical care and oncology. </sec> <sec> <title>METHODS</title> An initial list of 181 medications was compiled in consultation with pharmacist stakeholders from critical care and oncology specialties. A modified Delphi study was conducted over 3 rounds with a panel of 8 expert pharmacists selected for their clinical expertise, professional experience, and geographic location to ensure representation of diverse health care settings and medication administration practices. Panelists anonymously ranked statements on a 5-point Likert scale developed from a review of the literature with respect to the requirement for a specific administration line material for each medication; the need for, and type of, filtration required during administration; and the need for light protection during storage and administration of medications. After each round, items achieving 80% consensus were finalized. Those that did not achieve consensus were carried forward to the next round. This iterative approach allowed panelists to reconsider their ratings based on emerging group consensus and additional evidence shared by panelists between rounds. </sec> <sec> <title>RESULTS</title> A total of 1044 administration and storage requirements were assessed for a final list of 174 medications. In round 1, consensus was reached for 613 (58.7%) statements, with every statement being addressed and scored by the panelists. Panelists provided additional evidence sources for their decisions, and these were distributed to all panel members for round 2. All items were addressed and scored by the panelists. By the conclusion of round 3, consensus had been achieved for 697 (66.8%) statements, with all items being addressed and scored by the panelists. </sec> <sec> <title>CONCLUSIONS</title> This study developed consensus-based recommendations for the selection of administration line materials, the use of in-line filtration, and light protection for the administration and storage of a range of medications administered intravenously. The guidance will aid medication stability and efficacy and promote good clinical practice; it currently underpins a prototype bedside app for correct intravenous administration line selection for nursing and pharmacy staff in critical care and oncology units. </sec>
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 découle