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Med O.S.® for Formulary Management Network Result

Standardizing Norepinephrine Concentrations Reduces Waste, Enhances Safety, and Brings Infusions to the Patient Bedside

Study Overview

Situation

A health system aimed to standardize norepinephrine concentrations to reduce medication waste and align with ASHP (American Society of Health-System Pharmacists) Standardize 4 Safety (S4S) recommendations.

Business Case & Findings

Standardizing to ASHP S4S recommendations improves safety, efficiency, and prescribing compliance. Bainbridge Health identified variability in norepinephrine concentration utilization and recommended opportunities for standardization based on current health system prescribing practices.

Results

Upon implementation of Bainbridge Health recommendations, the health system successfully reduced norepinephrine concentrations by 50%, aligned with ASHP S4S recommendations and created a safer patient environment by adopting ready-to-use commercial formulations.

Situation

Bainbridge Health identified a wide variation in norepinephrine concentration utilization at a large hospital system across patient care units, contributing to medication waste, increased need for bedside compounding, and dosing confusion. As a critical vasopressor used in emergent situations like shock or severe hypotension, norepinephrine requires precise dosing and readily available formulations for administration. The pharmacy and clinical leadership teams sought to reduce concentration variability, align practices with ASHP Standardize 4 Safety recommendations, and improve infusion safety in critical care situations.

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Business Case

  • The ASHP highlights the benefits of standardizing I.V. formularies to improve patient safety, simplify EHR workflows for clinicians, and streamline operational processes within pharmacies.1
  • Analyzing infusion data has been demonstrated to result in standard concentrations and bag sizes that lead to reduced drug and fluid waste, cost-savings, and streamlined drug procurement and preparation processes.2
  • Pharmacy leadership further determined that Bainbridge Health’s Med O.S.® would provide the data-driven confidence required to champion this change and decrease time to intervention.

Intervention & Impact

Bainbridge Health conducted a comprehensive analysis of the hospital’s norepinephrine infusion utilization patterns, incorporating both hospital-specific data and national network benchmarking data. It quickly ascertained that this hospital system was simultaneously utilizing 4 different concentrations of this critical medication in various dispense volumes. Through hospital-specific data review and national network benchmarking, Bainbridge Health identified opportunities to reduce the number of concentrations and advocate for a standard 250 mL dispense volume, ensuring:

  • Alignment with ASHP S4S best practice recommendations
  • Operational efficiency by simplifying medication preparation and dispensing
  • Decrease drug waste without compromising clinical flexibility
  • Optionality to adopt ready-to-use commercially available formulations, bringing a critical medication directly to the patient bedside

By implementing these changes, the hospital reduced norepinephrine concentrations by 50% aligning with ASHP S4S guidelines, standardizing their dispensing practice, and improving patient safety. In addition to reducing waste, these changes minimized bedside compounding, streamlined nurse workflows, and strengthened infusion safety —delivering operational, safety, and financial value.

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Figure: Standardizing norepinephrine concentrations

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Disclaimer

This example is for informational purposes only and should not be relied upon to make specific clinician decisions.

All recommendations made by Bainbridge Health were evidence-based according to supporting literature and network data. They were also made under the surveillance of the Bainbridge Health Clinical Solutions team, an interdisciplinary group of subject matter experts who provide guidance and oversight.

References
1. Blum, K. ASHP’s standardize 4 safety initiative helps pharmacists reduce medication errors. ASHP Intersections. November 12, 2020.
2. Forshay CM, Hansen KN, Eckel SF. Using intravenous pump infusion data to optimize continuous infusion concentrations and reduce drug and fluid waste. Am J Health Syst Pharm. 2020 Sep 15;77(18):1497-1503. doi: https://doi.org/10.1093/ajhp/zxaa199

Ready to Harness the Full Potential of Your Infusion Data?

Learn how our solutions can help improve safety, efficiency, and pharmacy operations across your health system.

Contact Our Team