Keeping babies safe during emergencies.

Abstract

Background: Neonatal emergencies are high pressure situations requiring accurate medication prescribing and administration, and are prone to errors. Strategies to reduce cognitive burden on clinicians and reduce the time taken to source information about how to safely give medications are necessary to prevent errors during emergency care. Method(s): A new-born emergency medication book was developed with a multidisciplinary team including neonatology, emergency medicine, nursing and pharmacy. The book contains colour-coded sections for indications including resuscitation, shock, bleeding, infection, electrolyte abnormalities and seizures. It also lists preferred equipment size. Dosing advice was standardised to match the Victorian Perinatal Infant and Paediatric Emergency Retrieval (PIPER) service neonatal worksheet to prevent any errors arising during referral consultations. Result(s): Each double page spread caters to a single weight ranging from 300 g to 7 kg, and outlines medication information including dose, dilution, and infusion time (where applicable). The emergency book was rolled out to neonatal units, emergency departments, birthing suites, theatres and post-natal wards across a major metropolitan health service. Preliminary feedback has been positive with themes of faster access to medications during resuscitation, reduced cognitive load on the clinicians, and ease of use, particularly reported by emergency department nurses without neonatal resuscitation experience who have been called on to assist. Conclusion(s): This quality improvement initiative may reduce medication errors in neonatal emergencies. Ongoing quality assurance activities are planned following implementation.