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Standardization of continuous renal-replacement therapy fluids using a commercial product.
- Source :
-
American Journal of Health-System Pharmacy . 5/1/2012, Vol. 69 Issue 9, p786-793. 8p. 1 Chart. - Publication Year :
- 2012
-
Abstract
- Purpose. Patient safety and cost-control benefits achieved through a medical center's conversion to commercial fluids for continuous renal-replacement therapy (CRRT) are described. Summary. In keeping with national patient safety recommendations, a medical center undertook a quality-improvement initiative to increase the standardization of CRRT fluids and associated patient care practices. After a feasibility study to ascertain CRRT fluid usage patterns and baseline costs, an appropriate commercial product was selected. The transition was implemented over several months in a three-phase process entailing (1) conversion to a commercial product for regional citrate anticoagulation, (2) changing the standard formula on preprinted orders to one that modeled a commercial product, and (3) conversion to the actual commercial product as the standard. Thorough education of all parties involved, as well as modifications to preprinted orders, occurred during each phase of the project. The use of the commercial product reduced the need for pharmacy compounding of CRRT fluids by more than 80%. A postconversion cost analysis indicated sharp reductions of product and labor (i.e., compounding) expenses relative to estimated baseline costs, with estimated total savings of at least $399,290 during the first six months after the conversion initiative. Implementation challenges included the need to manually adjust the potassium content of the commercial CRRT fluid and the need to provide i.v. supplementation of phosphorus and magnesium to some patients receiving the fluid. The initiative emphasized the need for institution-specific research and planning before conversion initiatives targeting CRRT fluids and other critical therapies, as well as proper education and training of all parties involved. Conclusion. The standardization of CRRT fluids using commercially available products improved a medical center's compliance with patient safety standards and yielded substantial cost savings. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CITRATES
*DRUG dosage
*ACADEMIC medical centers
*ANTICOAGULANTS
*DIALYSIS (Chemistry)
*HEMODIALYSIS
*HOSPITAL costs
*EVALUATION of medical care
*MEDICATION errors
*ORGANIZATIONAL change
*PATIENT safety
*QUALITY assurance
*WATER-electrolyte balance (Physiology)
*COST analysis
*ECONOMICS
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 10792082
- Volume :
- 69
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- American Journal of Health-System Pharmacy
- Publication Type :
- Academic Journal
- Accession number :
- 74572622
- Full Text :
- https://doi.org/10.2146/ajhp110325