The preparation and administration of intravenous drugs before and after protocol implementation

Pharm World Sci. 2009 Jun;31(3):413-20. doi: 10.1007/s11096-008-9269-5. Epub 2008 Dec 3.


Objectives: This paper reports on a pilot study examining the incidence of nurses' errors in preparation and administration of intravenous drugs. Furthermore, the study aimed to evaluate the short-term effects of implementation of a new protocol for preparation and administration of intravenous drugs.

Setting: Two nursing departments of internal medicine at a 953 beds University Medical Centre in The Netherlands.

Methods: By means of a prospective, quasi-experimental design, nurses were observed during the process of preparation and administration of intravenous drugs. Observation was performed before and after the implementation of a new protocol. Seventy-two nurses at two nursing departments were observed during the study.

Main outcome measure: A mean pre-test and post-test quality score at two departments of internal medicine.

Results: At baseline, average quality scores for nurses at the two departments were 64 (intervention ward) and 67 (control ward) on a 0-100 quality scale. The pre-test quality scores were not statistically significant for the two nursing wards (T = 1.36, df = 55, P = 0.18). After the implementation of the new protocol, nurses at the intervention ward scored better (72) than nurses at the control ward (69). The mean score at the intervention ward was significantly higher than the score in nurses of the control ward (T = -2.20, df = 53, P = 0.04).

Conclusions: The number of errors in the preparation and administration of intravenous drugs is high. This study shows that implementing a protocol for the preparation and administration of these drugs can reduce the number of errors.

MeSH terms

  • Academic Medical Centers / methods
  • Academic Medical Centers / standards
  • Adult
  • Drug Compounding / methods
  • Drug Compounding / standards
  • Female
  • Humans
  • Infusions, Intravenous
  • Injections, Intravenous
  • Male
  • Medication Errors / prevention & control*
  • Medication Systems, Hospital / standards*
  • Middle Aged
  • Netherlands
  • Nursing Staff, Hospital / standards*
  • Pilot Projects
  • Practice Guidelines as Topic*
  • Young Adult