Purpose: The results of a 2008 survey by the U.S. Pharmacopeia (USP) Safe Medication Use Expert Committee assessing the use of standardized i.v. drug concentrations at U.S. health care institutions are presented.
Methods: To evaluate progress toward the goal of standardizing and limiting the number of i.v. infusion concentrations of high-risk medications, particularly those commonly used in pediatric patients, a USP-appointed expert committee surveyed a nationally representative sample of hospital and health-system pharmacy directors; 229 usable survey responses and 174 requested lists of routinely used or "standard" concentrations (i.e., those designed to meet the needs of at least 90% of the target adult, pediatric, and neonatal populations) were received.
Results: The survey responses indicated that multiple concentrations of high-risk drugs are still commonly used; in some instances, as many as four standard concentrations of a single medication were reported to be in use for a particular age group. Depending on the drug and target group, the proportion of respondents reporting the use of one standard concentration for a given drug ranged from 15% to 79%. The survey data informed and helped focus the USP expert committee's efforts to develop recommended standard concentrations for 10 high-alert drugs. Also presented in this article are general principles drafted by the USP committee to guide the development of local and national standard concentrations.
Conclusion: The results of a national USP survey indicate that many institutions do not use standard i.v. infusion concentrations of commonly used high-risk medications in adult, pediatric, or neonatal patient populations.