title: Implementation of standardized pediatric i.v. medication concentrations.
abstract: OBJECTIVE
  The development and implementation of a comprehensive and standardized list of pediatric i.v. medication concentrations across a large healthcare system are described.
  
  
  CONCLUSIONS
  In accordance with National Patient Safety Goals, facilities affiliated with the Hospital Corporation of America system had independently standardized and limited the number of drug concentrations in use. This resulted in variation among facilities, which prevented the systemwide standardization of drug dictionaries within the computerized pharmacy and prescriber-order-entry systems, complicated the movement of providers among facilities, and contributed to inconsistency in medication prescribing. A team of experts collaborated to create a comprehensive standard list that included 119 medications and 372 concentrations for pediatric i.v. medications. Implementation of this standard list was driven through a financial incentive from the malpractice insurance provider; facilities that completed the required activities for this optional program could apply for a credit of a portion of their malpractice insurance cost. For the standardization of pediatric i.v. medications, required activities included approval of the standard medication list, incorporation of this list into facility pharmacy dictionaries, and update of all smart pump software to include only the new standard medications and concentrations. Of the 145 facilities that were eligible for the implementation of standard pediatric i.v. medication concentrations, 141 (97%) completed all requirements and received the 2% malpractice insurance cost credit.
  
  
  CONCLUSIONS
  The use of a financial incentive strategy, in the form of a malpractice insurance credit, successfully motivated the implementation of standardized pediatric medication concentrations across a large healthcare system.
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN. kara.murray@hcahealthcare.com.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Murray
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN.
authors.forename: Dahna
authors.initials: D
authors.lastname: Wright
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN.
authors.forename: Bill
authors.initials: B
authors.lastname: Laxton
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN.
authors.forename: Karla M
authors.initials: KM
authors.lastname: Miller
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN.
authors.forename: Janet
authors.initials: J
authors.lastname: Meyers
authors.affiliation: Kara L. Murray, Pharm.D., BCPS, is Manager, Clinical Therapeutics and Pharmacy, Clinical Services Group; Dahna Wright, B.S.N., RN, is Director, Women's and Children's Clinical Services; Bill Laxton, B.S.N., RN, CPHRM, is Director, Risk and Patient Safety; Karla M. Miller, Pharm.D., BCPP, is Assistant Vice President, Pharmacy Services and Clinical Therapeutics; Janet Meyers, B.S.N., RN, M.B.A., is Assistant Vice President, Women's and Children's Services; and Jane Englebright, PH.D., B.S.N., RN, CENP, is Chief Nursing Officer and Vice-President, Clinical Services Group, Hospital Corporation of America, Nashville, TN.
authors.forename: Jane
authors.initials: J
authors.lastname: Englebright
mesh_terms: D006801:Humans; D007260:Infusion Pumps / Q000592:standards*; D008510:Medication Systems, Hospital / Q000592:standards*; D010372:Pediatrics / Q000592:standards*; D010607:Pharmacy Service, Hospital / Q000592:standards*; D012015:Reference Standards