6878 A quality improvement study analysing the compatibility of intravenous medications in neonates in a tertiary neonatal intensive care unit

Objectives Background: In a neonatal intensive care setting patients are often on multiple intravenous medications. Patients currently require different intravenous access in order to receive certain intravenous medications due to limited data between different medications on compatibility. By examining if intravenous medications with no or limited data on compatibility we hope to be able to improve the number of intravenous medications that can be run through access lines. Objective: To examine the potential for two intravenous medications with limited to no data regarding compatibility with each other to run through a single lumen in a neonate. Setting Tertiary Neonatal Unit in North West of England. Methods A compatibility chart was created that examined information about intravenous medications commonly used in a neonatal intensive care unit. Where data was unavailable regarding compatibility between two medications, pH's and additional information about compatibility was determined. The chart was reviewed by a neonatal consultant, paediatric trainee, and pharmacist. Charts with a standardised proforma was shared amongst neonatal staff. Intravenous medications that had been determined to have no information regarding compatibility between one another were coded as yellow. Data was collected for changes in colouration of IV line, changes in pressure, deterioration in the neonate due to the introduction of the medications or site reactions. Results Data was collected from March 2023 and is currently ongoing. To date 104 proformas have been completed, 3 were unable to be included due to missing information. There have been no adverse reactions or deteriorations in the neonates relating to the medication compatibilities to date. Three sets of medications have been determined to be compatible with one another; vancomycin and ciprofloxacin, metronidazole and vancomycin, and morphine sulfate and ciprofloxacin. There were 33 proformas for vancomycin and ciprofloxacin with one mild skin reaction, 13 proformas for ciprofloxacin and morphine sulphate with no reactions, and 12 proformas for vancomycin and metronidazole with no reactions. Conclusion The study highlights that certain intravenous medications are compatible and safe for the patient to run together through the same intravenous line. Ongoing data is required regarding other intravenous medications.