DEVELOPMENT OF AN EASY, SAFE AND EFFECTIVE METHOD TO IDENTIFY DRUG INCOMPATIBILITIES
Drug therapy is a complex process with innumerable parameters modulating its success and safety. The most vulnerable patients at risk of increased drug errors are those who require intensive care treatment. In such patients, multiple co-morbidity and multiorgan failure are frequent, with increasing mortality rate, oral drug treatment is often impossible in the initial phase of ICU admission. Making parenteral drug administration unavoidable. Parenteral drug administration is a standard that is often complicated by the fact that the number of concurrently administered drugs exceeds the number of available infusion lines, this potentiates drugs being administered through the same lumen/ line (Y- site administration), thus introducing another risk factor known as drug incompatibility (Thilo, 2008). Incompatibilities become a major risk in intensive care units (ICUs), due to the large portion of parenteral drug administrations, the need for constant drug infusions (e.g., Inotropes support) and the limited number of independent intravenous lines in critically ill patients.
Pharmacotherapeutic options have increased recently for intensive care units and have also been linked to the increasing complexity of drug treatment due to risk of medication errors and incompatibilities. According to Thilo et. al (2008), medication errors have been identified as a major factor limiting effectiveness and the safety of drug treatment. The errors are of particular importance for parenteral drug administrations are physiochemical incompatibilities of intravenous solutions as they impair the efficacy of the drug or increase the risk for adverse effects. Adverse effects of drug incompatibilities not only effects the drug efficacy but has financial impact as well, as it also extend periods of patients’ hospitalization and the total costs for hospitals (Josephson, D.L. 2006).
Josephson (2006) describes drug incompatibility as an undesirable reaction that occurs between the drugs and the solutions, container/ syringes/ tubing’s or another drug. The core types of incompatibilities associated with IV drug administration are physical, chemical or pharmacological. (Douglas, 2001). Drug incompatibility may lead not only to a reaction displayed by precipitation but also to an inhibition or alteration of a drug's therapeutic effect. Many factors are found to affect drug compatibility, including pH, temperature, concentration, ionic strength, drug container, duration of the infusion and exposure to light (Trissel, 2009). Despite high prevalence rate, only limited information on measures to reduce incompatibilities in daily practice in an ICU have been published. The objective of the study is to create a comprehensive and complete database of medication compatibility that will be relevant to the Critical Care Complex.
Awareness of risks linked to...