{
  "abstract": "Background The administration of continuous intravenous (IV) sedation is a routine but high-risk clinical activity in the paediatric critical care unit. Traditionally, these infusions are prepared at the bedside using weight-based calculations resulting in variable concentrations. In 2024, our incident reporting system captured 60 medication errors linked to infusion preparation and administration, though the true number is likely higher due to underreporting. Current practice introduces considerable risk to patient safety, including dosing errors, microbial contamination, which can result in line infections and increased antibiotic use, and consumes excessive nursing and pharmacy resources. The use of standardised concentration infusions is recommended by the Neonatal and Paediatric Pharmacy Group and the Royal College of Paediatrics and Child Health 1 and is in line with NHS England’s aseptic transformation agenda.2 Aim The study’s objectives are twofold: first, to quantify the amount of nursing time spent preparing IV infusion products within paediatric critical care; second, to model the impact of transitioning to ready–prepared syringes for three specific sedative medications: morphine, fentanyl, and midazolam.Method A paediatric pharmacist observed nursing staff during infusion preparation on paediatric critical care units over a period of three weeks. Nursing time and use of consumables were recorded. Retrospective reports of infusion prescriptions covering a period of 12 months were generated and stratified based on weight to calculate the median number of standard-concentration infusions required per month. Cost modelling analyses were performed using MS Excel.Results In the paediatric critical care unit, the average time required to prepare a sedation infusion by two nurses was 11 minutes. Cost modelling revealed that current monthly expenses for syringe preparation, including nursing time and consumables, are approximately £4,624. Use of standardised concentration infusions, despite higher cost per syringe, is projected to reduce costs to £4,112 per month, by releasing 122.1 hours of nursing time valued at £2,815 per month. This results in a net saving of £511 per month. Estimated one-off implementation costs include £784 for staff training and £1,000 for secure fridge storage.Conclusion This project demonstrates that transitioning to standardised, aseptically prepared sedation infusions is a clinically and economically viable strategy. It improves nursing efficiency and supports future scalability across the paediatric division. The modelled intervention could replace bespoke bedside preparations with a set of pre-defined weight-banded concentrations for morphine, fentanyl, and midazolam. These products, prepared in a grade A environment, offer improved sterility, quality assurance, and extended shelf lives. Implementation will require updates to electronic prescribing systems, stock control adjustments, and initial investment in appropriate storage facilities. Additional planning and staff training will ensure safe implementation.References Royal College of Paediatrics and Child Health (RCPCH), Neonatal and Paediatric Pharmacists Group (NPPG). Standardising intravenous infusion concentrations in children in the UK [Internet]. London: RCPCH; 2020 [accessed 2025 Jul 3]. Available from: https://www.rcpch.ac.uk/resources/standardising-intravenous-infusion-concentrations-children-ukDepartment of Health and Social Care. Transforming NHS pharmacy aseptic services in England: a national report by Lord Carter of Coles [Internet]. London: DHSC; 2020 [accessed 2025 Jul 3]. Available from: https://assets.publishing.service.gov.uk/media/5f9afdbdd3bf7f1e405d9a23/aseptic-pharmacy.pdf",
  "authors": [
    {
      "affiliations": [
        "Southampton Children’s Hospital, UK"
      ],
      "name": "Evia Kora"
    },
    {
      "affiliations": [
        "Southampton Children’s Hospital, UK"
      ],
      "name": "Amanda Bevan"
    }
  ],
  "title": "P34 Modelling the transition to standardised concentration infusions in paediatric critical care",
  "uid": "74dfcdf5-9731-53a8-ac17-f0bf04265491"
}