Assessment and optimization of infusion practices in paediatric oncology

Introduction An infusion line comprises several sterile medical devices to administer parenteral drugs. Several risks are associated with infusion practices and notably medication errors and physicochemical incompatibilities (PCIs). A multidisciplinary working group in our anti-cancer center created a standard infusion line in 2013; we also sought to improve prevention of PCIs. Materials and methods An assessment of professional practices concerning infusion lines in paediatric oncology was carried out in 2016. Nurses and physicians’ knowledge and awareness of PCI was estimated by a questionnaire. Results Forty-seven infusion lines were assessed: 22 had minor (47%) and 3 had major deviations (6%). Sixteen nurses (53%) and 8 doctors (47%) answered the questionnaire. Nurses were aware of more high-risk situations, but there were large variations in knowledge. A prevention manual listing pairwise drug-drug compatibility between 44 drugs, for a total of 946 drug-drug associations, was drawn up and accepted. Discussion and conclusion For 419 associations (44.3%), no data could be found in the literature, 414 (43.8%) were compatible and 113 (11.9%) incompatible. This work was carried out in association with the clinical departments, pharmacy and health-care director, to improve patient safety.