Standardize 4 Safety initiative finalizes list of recommendations for adult IV continuous infusions

ASHP announced that its Standardize 4 Safety initiative has finalized its list of recommended concentrations for adult IV continuous infusions. The list, which marks the first major milestone in Phase I of the initiative, is posted on ASHP's Standardize 4 Safety website. ASHP also announced today that it is now seeking comments and discussion on dosage recommendations for compounded oral liquids. The comment period begins today and will remain open for 60 days.

Standardize 4 Safety seeks to reduce IV and oral liquid medication errors as well as improve continuity of medications therapy for patients through transitions of care. The project is funded through FDA's Safe Use Initiative, an effort to reduce preventable harm from medications by creating and facilitating public and private collaborations with the healthcare community.

A recent report from patient-safety researchers at the Johns Hopkins School of Medicine claims that medical errors are the third leading cause of death in the United States, behind only heart disease and cancer. These errors, many of which involve IV and oral liquid medications, are especially prevalent during transitions of care.

"Through our Standardize 4 Safety campaign, ASHP is making a concerted effort to reduce medical errors," said Deborah Pasko, Pharm.D., M.H.A., ASHP's Director of Medication Safety and Quality and principal investigator for ASHP's Standardize 4 Safety initiative. "By combining the expertise of pharmacists with that of other healthcare professionals, Standardize 4 Safety seeks guiding principles that will help determine standardized concentrations for medications, which will ensure safe medication use and ultimately save lives."

The Standardize 4 Safety initiative consists of three phases. Phase I addresses concentrations and dosing units for adult continuous infusions and compounded oral liquids; Phase II addresses concentrations and dosing units for pediatric continuous infusions and standard doses of oral liquid medications; and Phase III addresses IV intermittent medications, patient-controlled analgesia (PCA) pumps, epidurals, and standard doses of oral chemotherapy agents.

Key partners in the initiative include the Association for the Advancement of Medical Instrumentation (AAMI), the Pediatric Pharmacy Advocacy Group (PPAG), and the Institute for Safe Medication Practices (ISMP). Expert panels involved in concentration selection include pharmacists, physicians, nurses, and other involved health professionals from a variety of healthcare organizations. Other local, state, and national organizations will also partner with ASHP for specific areas of the project, including testing, communication, and implementation.

ASHP is currently seeking comments and discussion on the initial draft of proposed standard concentrations for compounded oral liquid medications. The draft for these recommendations is expected to be posted in January 2017. More drafts will follow as the initiative proceeds.