title: Implementation of standardized dosing units for i.v. medications.
abstract: OBJECTIVE
  The implementation of standardized dosing units for six i.v. medications at an academic medical center is described.
  
  
  CONCLUSIONS
  During the implementation of an electronic health record system at an academic medical center, it was noticed that providers could order some i.v. medications in multiple dosing units, including epinephrine, isoproterenol, midazolam, nitroglycerin, norepinephrine, and phenylephrine. Possible options to standardize i.v. medications along with their pros and cons were presented for discussion to key providers in all of the intensive care units. Once the providers agreed on a solution, the information was presented to the pharmacy and therapeutics committee for final approval. A nursing education plan was created and administered before the standardization of dosing units was implemented. A nursing survey was conducted before and after implementation of dosing-unit standardization to determine the effectiveness of nursing education on compliance with the standardization of the dosing units for the listed medications. The survey was designed to evaluate, when given a choice, what dosing units nurses would use to administer epinephrine, isoproterenol, midazolam, nitroglycerin, norepinephrine, and phenylephrine. The decision was made by the key providers to use weight-based dosing-micrograms per kilograms per minute-to allow for consistency of use of these medications for pediatric and adult patients. Nursing education was completed to ensure that nurses were aware of how to safely administer these medications using the new dosing units.
  
  
  CONCLUSIONS
  Dosing-unit standardization for dose-adjustable i.v. infusions can provide improved consistency and decrease the potential for dosing errors when administering epinephrine, isoproterenol, midazolam, nitroglycerin, norepinephrine, and phenylephrine.
authors.affiliation: Benjamin Jung, Pharm.D., M.P.A., is Health System Pharmacy Administration Resident; Rick Couldry, M.S., B.S.Pharm., is Director of Pharmacy and Postgraduate Year 2 Health System Pharmacy Administration Residency Director; and Samaneh Wilkinson, M.S., Pharm.D., is Clinical Manager and Postgraduate Year 1 Residency Director, University of Kansas Hospital, Kansas City. Dennis Grauer, Ph.D., M.S., is Associate Professor and Graduate Program Director, University of Kansas, Lawrence. benjamin.jung@ministryhealth.org.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Jung
authors.affiliation: Benjamin Jung, Pharm.D., M.P.A., is Health System Pharmacy Administration Resident; Rick Couldry, M.S., B.S.Pharm., is Director of Pharmacy and Postgraduate Year 2 Health System Pharmacy Administration Residency Director; and Samaneh Wilkinson, M.S., Pharm.D., is Clinical Manager and Postgraduate Year 1 Residency Director, University of Kansas Hospital, Kansas City. Dennis Grauer, Ph.D., M.S., is Associate Professor and Graduate Program Director, University of Kansas, Lawrence.
authors.forename: Rick
authors.initials: R
authors.lastname: Couldry
authors.affiliation: Benjamin Jung, Pharm.D., M.P.A., is Health System Pharmacy Administration Resident; Rick Couldry, M.S., B.S.Pharm., is Director of Pharmacy and Postgraduate Year 2 Health System Pharmacy Administration Residency Director; and Samaneh Wilkinson, M.S., Pharm.D., is Clinical Manager and Postgraduate Year 1 Residency Director, University of Kansas Hospital, Kansas City. Dennis Grauer, Ph.D., M.S., is Associate Professor and Graduate Program Director, University of Kansas, Lawrence.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Wilkinson
authors.affiliation: Benjamin Jung, Pharm.D., M.P.A., is Health System Pharmacy Administration Resident; Rick Couldry, M.S., B.S.Pharm., is Director of Pharmacy and Postgraduate Year 2 Health System Pharmacy Administration Residency Director; and Samaneh Wilkinson, M.S., Pharm.D., is Clinical Manager and Postgraduate Year 1 Residency Director, University of Kansas Hospital, Kansas City. Dennis Grauer, Ph.D., M.S., is Associate Professor and Graduate Program Director, University of Kansas, Lawrence.
authors.forename: Dennis
authors.initials: D
authors.lastname: Grauer
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000328:Adult; D001291:Attitude of Health Personnel; D064648:Critical Care Nursing / Q000193:education / Q000592:standards; D057286:Electronic Health Records / Q000458:organization & administration / Q000639:trends; D006801:Humans; D007262:Infusions, Intravenous / Q000451:nursing / Q000592:standards; D007318:Inservice Training; D007615:Kansas; D050316:Medical Order Entry Systems / Q000458:organization & administration / Q000592:standards*; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000458:organization & administration / Q000592:standards*; D019982:Organizational Case Studies; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000592:standards; D012015:Reference Standards; D017751:Safety Management / Q000379:methods / Q000458:organization & administration / Q000592:standards*