IV Administration

It is well known and accepted that the incidence of errors in prescribing, preparing, and administering injectable medicines is higher than that for other forms of medicine.

All human actions are prone to errors, and each step in the prescribing, preparing, administering, and monitoring of injectable medicines is risky.

Adopting a safe system of work and following a few simple rules can minimise the risks and significantly improve patient safety.

The National Reporting and Learning System (NRLS) of the UK’s National Patient Safety Agency (now part of the National Commissioning Board SHA) received over 526 000 reports of incidents relating to medicines between January 2005 and December 2010; over half of these were related to the administration of drugs. Just over 86 800 of these caused harm and 271 incidents resulted in death. However, this probably represents only a fraction of all such incidents.

preparation of injectable medicines is a highly complex process, involving many steps where errors can happen. Problems in preparing and administering injectable medicines account for 62 % of all medicine safety incidents reported to the NRLS as leading to death or severe harm.

Human factors affecting healthcare professionals can contribute. These include:

• Tiredness
• Poor concentration
• Lack of support
• Lack of familiarity with the prescribed medicine or protocols.
• Stress outside of work

It is accepted that stress may be associated with a change in cognition and behaviour, and that this can result in reduced performance and mistakes in sequential procedures. Put more simply, stress may lead to mistakes.

System factors (for example a busy, noisy ward environment), staff shortages, and lack of supervision can also have a significant impact.