Despite repeated warnings, neonates continue to be given heparin overdoses, the Institute for Safe Medication Practices (ISMP) reports.
There is no standard dosing protocol for using heparin to clear venous and arterial lines in neonates, according to ISMP. This means a hospital might stock heparin solutions in several concentrations, making errors more likely.
The chance of errors also increases when heparin is stocked in unfamiliar concentrations and if pharmacies don’t verify the concentration of a heparin solution before dispensing.
ISMP suggests that:
- Pharmacies prepare and dispense heparin flush solutions, rather than having nurses do this in patient care areas.
- Hospitals use pre-filled heparin flush syringes, which are now available in several concentrations.
- Hospitals also can use spectroscopy equipment to check accuracy.
- Hospitals that outsource preparations of neonatal heparin flush products make sure to use commercial manufacturers who meet the FDA’s good manufacturing practices and assay their solutions before distribution.