title: Multiple Intravenous Infusions Phase 2b: Laboratory Study.
abstract: BACKGROUND
  Administering multiple intravenous (IV) infusions to a single patient via infusion pump occurs routinely in health care, but there has been little empirical research examining the risks associated with this practice or ways to mitigate those risks.
  
  
  OBJECTIVE
  To identify the risks associated with multiple IV infusions and assess the impact of interventions on nurses' ability to safely administer them.
  
  
  METHODS
  Forty nurses completed infusion-related tasks in a simulated adult intensive care unit, with and without interventions (i.e., repeated-measures design).
  
  
  RESULTS
  Errors were observed in completing common tasks associated with the administration of multiple IV infusions, including the following (all values from baseline, which was current practice): setting up and programming multiple primary continuous IV infusions (e.g., 11.7% programming errors)identifying IV infusions (e.g., 7.7% line-tracing errors)managing dead volume (e.g., 96.0% flush rate errors following IV syringe dose administration)setting up a secondary intermittent IV infusion (e.g., 11.3% secondary clamp errors)administering an IV pump bolus (e.g., 11.5% programming errors)Of 10 interventions tested, 6 (1 practice, 3 technology, and 2 educational) significantly decreased or even eliminated errors compared to baseline.
  
  
  CONCLUSIONS
  The simulation of an adult intensive care unit at 1 hospital limited the ability to generalize results. The study results were representative of nurses who received training in the interventions but had little experience using them. The longitudinal effects of the interventions were not studied.
  
  
  CONCLUSIONS
  Administering and managing multiple IV infusions is a complex and risk-prone activity. However, when a patient requires multiple IV infusions, targeted interventions can reduce identified risks. A combination of standardized practice, technology improvements, and targeted education is required.
authors: HumanEra, University Health Network, Toronto, Ontario, Canada.
authors: Sonia
authors: S
authors: Pinkney
authors: HumanEra, University Health Network, Toronto, Ontario, Canada.
authors: Mark
authors: M
authors: Fan
authors: HumanEra, University Health Network, Toronto, Ontario, Canada ; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
authors: Katherine
authors: K
authors: Chan
authors: Institute for Safe Medication Practices Canada, Toronto, Ontario, Canada.
authors: Christine
authors: C
authors: Koczmara
authors: HumanEra, University Health Network, Toronto, Ontario, Canada.
authors: Christopher
authors: C
authors: Colvin
authors: HumanEra, University Health Network, Toronto, Ontario, Canada ; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
authors: Farzan
authors: F
authors: Sasangohar
authors: HumanEra, University Health Network, Toronto, Ontario, Canada.
authors: Caterina
authors: C
authors: Masino
authors: HumanEra, University Health Network, Toronto, Ontario, Canada ; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
authors: Anthony
authors: A
authors: Easty
authors: HumanEra, University Health Network, Toronto, Ontario, Canada ; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada ; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors: Patricia
authors: P
authors: Trbovich
mesh_terms: D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects*; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000379:methods / Q000451:nursing; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D009732:Nursing Care; D012307:Risk Factors; D011795:Surveys and Questionnaires