Standardize When Possible (CUSP Science of Safety) (continued) Key Perinatal Safety Examples Elements Standardize magnesium sulfate If a infusion pump with these safety dosing a calibrated infusion features is not available, then loading dose pump with free-flow protection. should be administered via a separate bag. (continued) Premixed or pharmacy-prepared bags (e.g., 4 g/100 ml or 8 g/100 ml) should be used unitwide to reduce variability and risk of error. The same standard preparation either premixed or pharmacy-prepared bags (e.g., 20 g/500-ml bag) unitwide for maintenance infusion.13 Use of a 500-ml bag can help distinguish the bag from liter bags containing fluids or other medications.11 The smaller volume also reduces the amount of magnesium that can be delivered in the event of an accidental rapid infusion (e.g., pump programming error or failure). Complete removal of the line from the intravenous (IV) port when magnesium sulfate therapy is discontinued to avoid accidental infusion.10,11 Use uniform parameters for The use of uniform parameters for fetal and maternal maternal and fetal monitoring monitoring and provider notification before and during and provider notification prior to magnesium sulfate use minimizes variability across initiation of magnesium sulfate providers and nursing staff in order to reduce the risk and during infusion. of error. Standardize laboratory Hospital policy and process for uniform reporting of reporting of serum magnesium serum magnesium levels. Magnesium levels can be levels. reported as milligrams per deciliter (mg/dL), milliequivalents per liter (mEq/L) and millimoles per liter (mmmol/L), and the same magnesium level would be reported using different numbers depending on the unit of measure. Bedside staff, providers, and lab personnel should agree on one unit for reporting and communicating magnesium levels to avoid miscommunication and delays in timely care.10 Create Independent Checks (CUSP Science of Safety) Key Perinatal Safety Examples Elements
Standardize When Possible (CUSP Science of Safety) (continued) Key Perinatal Safety Elements Examples Standardize magnesium sulfate dosing a calibrated infusion pump with free-flow protection. (continued) If a infusion pump with these safety features is not available, then loading dose should be administered via a separate bag. Premixed or pharmacy-prepared bags (e.g., 4 g/100 ml or 8 g/100 ml) should be used unitwide to reduce variability and risk of error. The same standard preparation either premixed or pharmacy-prepared bags (e.g., 20 g/500-ml bag) unitwide for maintenance infusion.13 Use of a 500-ml bag can help distinguish the bag from liter bags containing fluids or other medications.11 The smaller volume also reduces the amount of magnesium that can be delivered in the event of an accidental rapid infusion (e.g., pump programming error or failure). Complete removal of the line from the intravenous (IV) port when magnesium sulfate therapy is discontinued to avoid accidental infusion.10,11 Use uniform parameters for maternal and fetal monitoring and provider notification prior to initiation of magnesium sulfate and during infusion. The use of uniform parameters for fetal and maternal monitoring and provider notification before and during magnesium sulfate use minimizes variability across providers and nursing staff in order to reduce the risk of error. Standardize laboratory reporting of serum magnesium levels. Hospital policy and process for uniform reporting of serum magnesium levels. Magnesium levels can be reported as milligrams per deciliter (mg/dL), milliequivalents per liter (mEq/L) and millimoles per liter (mmmol/L), and the same magnesium level would be reported using different numbers depending on the unit of measure. Bedside staff, providers, and lab personnel should agree on one unit for reporting and communicating magnesium levels to avoid miscommunication and delays in timely care.10 Create Independent Checks (CUSP Science of Safety) Key Perinatal Safety Elements Examples
tool_safe-mgso4.docx