Enhanced photoemission spectroscopy for verification of high-risk i.v. medications.
OBJECTIVE
The sensitivity and specificity of enhanced photoemission spectroscopy (EPS) for performing an automated final check of compounded i.v. admixtures at a pediatric hospital pharmacy were studied.


METHODS
A tabletop EPS device was used to test samples of seven high-risk drug-diluent combinations compounded in the pharmacy; the drugs were vancomycin, lorazepam, morphine, insulin, hydromorphone, gentamicin, and epinephrine. Ten sets of samples were prepared for each drug. Typically, a sample set consisted of dilutions ranging from 10-fold above to 10-fold below the targeted concentration. Testing was performed twice weekly between November 2005 and March 2006.


RESULTS
The EPS device detected errors departing from the targeted concentration by 20% or more with a sensitivity of at least 95%. Specificity in distinguishing among test medications at targeted concentrations was 100%. The percentage of passing samples with intermediate concentrations varied among the drugs.


CONCLUSIONS
A tabletop EPS device demonstrated acceptable sensitivity and specificity for validating the identity and concentrations of selected high-risk i.v. medications compounded for pediatric patients. The device may help prevent clinically important medication errors caused by inaccurate compounding.
Kaakeh
Yaman
Y
Purdue University, West Lafayette, IN, USA.
Phan
Hanna
H
DeSmet
Brian D
BD
Pasko
Deborah A
DA
Glenn
Denise K
DK
Stevenson
James G
JG
D004339:Drug Compounding / Q000592:standards*; D004355:Drug Stability; D006776:Hospitals, Pediatric; D006801:Humans; D007262:Infusions, Intravenous; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital; D010607:Pharmacy Service, Hospital; D010865:Pilot Projects; D011786:Quality Control; D015203:Reproducibility of Results; D017751:Safety Management; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis / Q000379:methods