Thank you for presenting a critical discussion in our anesthesia practice. My group is very invested in medication safety, and we perform mandatory 2-person infusion verification in every anesthetic. For solo providers, I suggest a few tools already available in the electronic anesthesia record and data collection. One is the displayed “calculated dose” for the child when the provider enters the medication and its intended “dose/weight” in the record; the other is the “calculate rate” when the provider enters the intentional “dose/weight/time” in the electronic record for infusions. The “calculated rate” should cross-check with the infusion rate being delivered to the patient. A provider may need to perform this step multiple times in a given anesthetic and with multiple infusions sometimes.
Another important habit is to save or retain all vials during the case. This step allows you to verify the medication source with colleagues, especially during hand-offs where the other provider would like to “trust but verify” what has been prepared in each syringe or delivered to the child.
Finally, we are implementing barcode medication administration (BCMA) where, instead of manually entering the documentation of drugs in the record, we scan the drug or prefilled syringe into the electronic record. This practice is as close as we can get to achieve the 5 “rights” of medication administration in anesthesia.
Thank you for presenting a critical discussion in our anesthesia practice. My group is very invested in medication safety, and we perform mandatory 2-person infusion verification in every anesthetic. For solo providers, I suggest a few tools already available in the electronic anesthesia record and data collection. One is the displayed “calculated dose” for the child when the provider enters the medication and its intended “dose/weight” in the record; the other is the “calculate rate” when the provider enters the intentional “dose/weight/time” in the electronic record for infusions. The “calculated rate” should cross-check with the infusion rate being delivered to the patient. A provider may need to perform this step multiple times in a given anesthetic and with multiple infusions sometimes.
Another important habit is to save or retain all vials during the case. This step allows you to verify the medication source with colleagues, especially during hand-offs where the other provider would like to “trust but verify” what has been prepared in each syringe or delivered to the child.
Finally, we are implementing barcode medication administration (BCMA) where, instead of manually entering the documentation of drugs in the record, we scan the drug or prefilled syringe into the electronic record. This practice is as close as we can get to achieve the 5 “rights” of medication administration in anesthesia.