title: Exploring the Current Landscape of Intravenous Infusion Practices and Errors (ECLIPSE): protocol for a mixed-methods observational study.
abstract: BACKGROUND
  Intravenous medication is essential for many hospital inpatients. However, providing intravenous therapy is complex and errors are common. 'Smart pumps' incorporating dose error reduction software have been widely advocated to reduce error. However, little is known about their effect on patient safety, how they are used or their likely impact. This study will explore the landscape of intravenous medication infusion practices and errors in English hospitals and how smart pumps may relate to the prevalence of medication administration errors.
  
  
  METHODS
  This is a mixed-methods study involving an observational quantitative point prevalence study to determine the frequency and types of errors that occur in the infusion of intravenous medication, and qualitative interviews with hospital staff to better understand infusion practices and the contexts in which errors occur. The study will involve 5 clinical areas (critical care, general medicine, general surgery, paediatrics and oncology), across 14 purposively sampled acute hospitals and 2 paediatric hospitals to cover a range of intravenous infusion practices. Data collectors will compare each infusion running at the time of data collection against the patient's medication orders to identify any discrepancies. The potential clinical importance of errors will be assessed. Quantitative data will be analysed descriptively; interviews will be analysed using thematic analysis.
  
  
  BACKGROUND
  Ethical approval has been obtained from an NHS Research Ethics Committee (14/SC/0290); local approvals will be sought from each participating organisation. Findings will be published in peer-reviewed journals and presented at conferences for academic and health professional audiences. Results will also be fed back to participating organisations to inform local policy, training and procurement. Aggregated findings will inform the debate on costs and benefits of the NHS investing in smart pump technology, and what other changes may need to be made to ensure effectiveness of such an investment.
authors.affiliation: UCL Interaction Centre, London, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Blandford
authors.affiliation: UCL Interaction Centre, London, UK.
authors.forename: Dominic
authors.initials: D
authors.lastname: Furniss
authors.affiliation: UCL Interaction Centre, London, UK.
authors.forename: Imogen
authors.identifier: http://orcid.org/0000-0002-9802-1795
authors.initials: I
authors.lastname: Lyons
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Chumbley
authors.affiliation: UCL Interaction Centre, London, UK.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Iacovides
authors.affiliation: Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.affiliation: UCL Interaction Centre, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Cox
authors.affiliation: UCL Medical School, University College London, London, UK.
authors.forename: Astrid
authors.initials: A
authors.lastname: Mayer
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Schnock
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: David Westfall
authors.initials: DW
authors.lastname: Bates
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Dykes
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Bell
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: Bryony Dean
authors.initials: BD
authors.lastname: Franklin
mesh_terms: D002648:Child; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008508:Medication Errors / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000592:standards*; D012107:Research Design; D013222:State Medicine
keywords: AUDIT