Validation Of A Developed Tool To Identify Compatibility Of Drug-Drug And Drug-Parenteral Nutrition In Neonates And Evaluation Of Clinical Outcome Of The Administration Of The Iv Drugs And Parenteral Nutrition
Loading...
Date
2016-02
Authors
Yelly, Oktavia Sari
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Intravenous drug administration in neonatal intensive care unit (NICU) is critical because of poor venous access, polymedication, fluid restriction and low infusion rate. Since parenteral nutrition (PN) is infused intravenously, it is often considered as a vehicle for medication administration. Medications may be added to PN formulations in an effort to decrease fluid requirements, reduce the need for Y-site injections, reduce the possibility of line contamination due to manipulation and decrease labor time required for drug administration. Risk is further increased by inadequate information on the physicochemical compatibility of drugs. This study aimed to evaluate clinical outcome of the administration of IV drugs and PN among neonates patients who had received PN during their hospitalization and to develop a data base on compatibility of drug-drug and drug-PN solution. A cross-sectional retrospective study design has been adopted to conduct this study. Subjects of this research were neonates’ patients receiving PN in Neonatal Intensive Care Unit (NICU) Hospital Pulau Pinang, Malaysia. Study subjects were all patients admitted in NICU from January 2008 until December 2009. Sampling procedure was universal sampling by collecting all available patients’ medical record that met our inclusion and exclusion criteria. A total of 234 newborn met the study criteria were included in this study. Self-developed data collection form was used with only single data collector for data collection. Approval for ethical clearance was obtained from the local institutions (Clinical Research Committee, CRC) and from the Ministry of Health Research Ethics Committee (MREC). Data was statistically analyzed using Statistic Package for Social Science 15.0 (SPSS 15.0). All 234 (100%) patients admitted to NICU Hospital Pulau Pinang were included. Among them, majority 123 (52.6%) were females and the rest 111 (47.4) were males. Ethnic distribution showed predominance of Malay with 158 (67.5%) followed by Chinese 41 (17.5%), Indian 23 (9.8%) and 12 (5.1%) others. Most of the patients; 98 (41.8%) were born at 28-31 weeks of gestation and 156 (66.67%) were in the body weight range of 1001-2000 grams. Patient related characteristics (birth weight, gestation age, mode of delivery and ethnicity) have significant association with PN practices and clinical outcomes. A developed database “My. Drug Compatibility Checker (My.DCC)” will provide the compatibility information related to drug-drug and drug-PN interaction among IV drugs commonly prescribed in NICU patients. Database My.DCC consider as validate and reliable tool to provide information regarding compatibility and drug-drug interactions of admixture in parenteral nutrition solutions. The concept, design and contents required for this prototype were researched, collected and provided by researcher. One systems analyst was involved to carry out the programming of the system. The 29 injectable drugs had been analyzed with My.DCC. The database was used to check the possible compatibility of medication combination received during patient’s treatment in NICU Hospital Pulau Pinang. The My.DCC finding showed that among 29 drugs that administered to the patients; 4 drugs combination were compatible in syringe, 2 drugs combination were incompatible in syringe, 25 drugs combination were compatible in Y-site injection and 8 drugs were incompatible in Y-site injection. Among them 19 neonates had incompatible interaction of drug-drug and drug-parenteral nutrition interaction. Recognition of these drug-drug and drug nutrient interactions may assist the clinician to prevent complications and to achieve desired therapeutics outcomes.
Description
Keywords
Drug