Avoiding incompatible drug pairs in central-venous catheters of patients receiving critical care: an algorithm-based analysis and a staff survey.

Purpose: In a critical care setting, we aimed to identify and solve physico-chemical drug incompatibilities in central-venous catheters considering the staffs' knowledge and assumptions about incompatibilities. Methods: (i) After positive ethical vote, an algorithm to identify incompatibilities was...

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Publicado en:European Journal of Clinical Pharmacology Vol. 79; no. 8; pp. 1081 - 1090
Autores principales: Wagner, Leonhardt Alexander Fabian, Neininger, Martina Patrizia, Hensen, Jan, Zube, Olaf, Bertsche, Thilo
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2023
      vid: 79
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-023-03509-0
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        atl: Avoiding incompatible drug pairs in central-venous catheters of patients receiving critical care: an algorithm-based analysis and a staff survey.
      aug:
        au:
          Wagner, Leonhardt Alexander Fabian
          Neininger, Martina Patrizia
          Hensen, Jan
          Zube, Olaf
          Bertsche, Thilo
        affil: Bundeswehr Hospital, Hamburg, Germany
      sug:
        subj:
          Critically Ill Patients
          Critical Care
          Central Venous Catheters
          Drug Incompatibility
          Attitude of Health Personnel
          Professional Knowledge
          Human
          Algorithms
          Questionnaires
          Descriptive Statistics
          Adult
          Patient Safety
          Adult: 19-44 years
      ab: Purpose: In a critical care setting, we aimed to identify and solve physico-chemical drug incompatibilities in central-venous catheters considering the staffs' knowledge and assumptions about incompatibilities. Methods: (i) After positive ethical vote, an algorithm to identify incompatibilities was developed and applied. The algorithm was based on KIK® database and Stabilis® database, the drug label, and Trissel textbook. (ii) A questionnaire was created and used that asked staff for knowledge and assumptions about incompatibilities. (iii) A 4-step avoidance recommendation was developed and applied. Results: (i) At least one incompatibility was identified in 64 (61.4%) of 104 enrolled patients. Eighty one (62.3%) of 130 incompatible combinations affected piperacillin/tazobactam and in 18 (13.8%) each furosemide and pantoprazole. (ii) 37.8% (n = 14) of the staff members participated in the questionnaire survey (median age: 31, IQR: 4.75 years). The combination of piperacillin/tazobactam and pantoprazole was incorrectly judged to be compatible by 85.7%. Only rarely felt the majority of respondents unsafe in administering drugs (median score: 1; 0, never to 5, always). (iii) In those 64 patients with at least one incompatibility, 68 avoidance recommendations were given, and all were fully accepted. In 44 (64.7%) of 68 recommendations "Step 1: Administer sequentially" was suggested as a avoidance strategy. In 9/68 (13.2%) "Step 2: Use another lumen", in 7/68 (10.3%) "Step 3: Take a break", and in 8/68 (11.8%) "Step 4: Use catheters with more lumens" were recommended. Conclusions: Although incompatibilities were common, the staff rarely felt unsafe when administering drugs. Knowledge deficits correlated well with the incompatibilities identified. All recommendations were fully accepted.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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