Standardising intravenous infusion concentrations in children in the UK

The Neonatal and Paediatric Pharmacy Group (NPPG), with support from the Royal College of Paediatrics of Child Health (RCPCH) has produced a proposal for a national approach for standardised intravenous infusion concentrations in children.

This framework document has now been updated, The NPPG and BAPM have worked together to update this framework and introduce some NICU concentrations for some of the drugs listed in the Infusion Standardisation Framework. This was supported by RCPCH and Joint RCPCH/NPPG Standing Committee on Medicines (JMC) and this framework aims to provide a list of standardised intravenous infusion concentrations for use in infants over 2 kg and children.

The framework brings standardisation of infusions one step closer, through the use of safer standard fixed concentrations replacing previous weight-based variable concentrations of infusions. In particular, by providing support for the development of a national ‘smart pump’ library, medication safety will be improved in this high risk area of practice.

The framework also provides the opportunity to provide and support additional efficiencies and safety initiatives by reducing the time taken to prepare infusions; safer prescribing and administration for practitioners moving between different workplaces who will become familiar with the standard concentrations in all settings; improved demand and capacity planning to manage drug shortages; improve the use of technology through implementation of smart pumps, use of electronic prescribing and implementation of barcoded medicines administration.

The framework provides a further opportunity for the development of licensed ready-to-administer formulations of IV medications based on the standard infusion concentrations.

We encourage all practitioners and providers of care to children and young people to review and implement the recommendations in this document. Further, we commend this framework to those national organisations committed to improve safety of medicines in children.