{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T20:18:20Z","timestamp":1767125900643,"version":"3.48.0"},"reference-count":18,"publisher":"The Pediatric Pharmacy Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Owing to a rise in potentially serious errors with parenteral prostacyclin infusions associated with using an unfamiliar MedFusion 3500 syringe pump (MedFusion), we implemented a comprehensive continuous process improvement (CPI) project to increase the overall safety of prostacyclins. The objective of this report was to describe the project\u2019s methodology and assess its impact on the number of errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A multidisciplinary team targeted 3 error-prone phases of prostacyclin delivery\u2014ordering, preparation and dispensing, and administration\u2014with CPI between January and October 2019. CPI involved standardizing the ordering process in the electronic health record, fully using the safety features of the MedFusion syringe pump, developing an electronically accessible job aid, and providing ongoing bedside education. A retrospective analysis of errors related to prostacyclin infusion was conducted from January 2013 to December 2023, covering both periods before and after CPI completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Before CPI, there were 1471 days of prostacyclins and 27 errors, or 1.8 per 100 patient days. After CPI, there were 1512 days of prostacyclins and 5 errors, or 0.3 per 100 patient days. After CPI, the age at start of infusion was lower, and the average length of infusion increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Our multidisciplinary comprehensive CPI decreased errors associated with prostacyclin infusions on the MedFusion pump, and continuous efforts have maintained low error rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5863\/jppt-25-00033","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T15:57:21Z","timestamp":1765814241000},"page":"800-806","source":"Crossref","is-referenced-by-count":0,"title":["Reduction in Prostacyclin Infusion Errors Following a Comprehensive Multidisciplinary Process Transformation for Hospitalized Pediatric Patients with Pulmonary Hypertension: A Quality Improvement Project"],"prefix":"10.5863","volume":"30","author":[{"given":"Christa","family":"Kirk","sequence":"first","affiliation":[{"name":"Duquesne University School of Pharmacy (CJK), Pittsburgh, PA"},{"name":"Heart Center (AD, CJK DY), Seattle Children\u2019s Hospital, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Davis","sequence":"additional","affiliation":[{"name":"Heart Center (AD, CJK DY), Seattle Children\u2019s Hospital, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delphine","family":"Yung","sequence":"additional","affiliation":[{"name":"Heart Center (AD, CJK DY), Seattle Children\u2019s Hospital, Seattle, WA"},{"name":"Department of Pediatrics, Division of Cardiology (DY), University of Washington School of Medicine, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"5","key":"JPPT-25-00033-b01","series-title":"N Engl J Med","first-page":"296","article-title":"A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension","volume":"334","author":"Barst","year":"1996","unstructured":"Barst RJ, Rubin LJ, Long WA, et al. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med. 1996;334(5):296\u2013301."},{"issue":"6","key":"JPPT-25-00033-b02","series-title":"Circulation","first-page":"660","article-title":"Outcomes in children with idiopathic pulmonary arterial hypertension","volume":"110","author":"Yung","year":"2004","unstructured":"Yung D, Widlitz AC, Rosenzweig EB, et al. Outcomes in children with idiopathic pulmonary arterial hypertension. Circulation. 2004;110(6):660\u2013665."},{"issue":"21","key":"JPPT-25-00033-b03","series-title":"Circulation","first-page":"2037","article-title":"Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society","volume":"132","author":"Abman","year":"2015","unstructured":"Abman SH, Hansmann G, Archer SL, et al. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation. 2015;132(21):2037\u20132099."},{"issue":"8","key":"JPPT-25-00033-b04","series-title":"J Heart Lung Transplant","first-page":"841","article-title":"Prostacyclin administration errors in pulmonary arterial hypertension patients admitted to hospitals in the United States: a national survey","volume":"29","author":"Kingman","year":"2010","unstructured":"Kingman MS, Tankersley MA, Lombardi S, et al. Prostacyclin administration errors in pulmonary arterial hypertension patients admitted to hospitals in the United States: a national survey. J Heart Lung Transplant. 2010;29(8):841\u2013846."},{"issue":"11","key":"JPPT-25-00033-b05","series-title":"Am J Health Syst Pharm","first-page":"768","article-title":"Catastrophic circulatory collapse after inadvertent subcutaneous injection of treprostinil","volume":"75","author":"Radosevich","year":"2018","unstructured":"Radosevich JJ, Dutt M, and Feldman J. Catastrophic circulatory collapse after inadvertent subcutaneous injection of treprostinil. Am J Health Syst Pharm. 2018;75(11):768\u2013772."},{"article-title":"Research Triangle, NC: United Therapuetics","year":"2023","key":"JPPT-25-00033-b06","unstructured":"CADD-MS3 Ambulatory Infusion Pump (treprostinil) [Injection information]. Research Triangle, NC: United Therapuetics; 2023. Accessed: August 24, 2024. https:\/\/www.remodulinpro.com\/pump-options\/subcutaneous"},{"issue":"4","key":"JPPT-25-00033-b07","series-title":"CHEST","first-page":"749","article-title":"Pulmonary Hypertension Care Center Network: Improving care and outcomes in pulmonary hypertension","volume":"151","author":"Sahay","year":"2017","unstructured":"Sahay S, Melendres-Groves L, Pawar L, et al. Pulmonary Hypertension Care Center Network: Improving care and outcomes in pulmonary hypertension. CHEST. 2017;151(4):749\u2013754."},{"issue":"4","key":"JPPT-25-00033-b08","series-title":"Crit Care Nurse","first-page":"e1","article-title":"Improving safety of intravenous prostacyclin administration to pediatric patients with pulmonary hypertension","volume":"39","author":"McSweeney","year":"2019","unstructured":"McSweeney J, Rosenholm E, Penny K, et al. Improving safety of intravenous prostacyclin administration to pediatric patients with pulmonary hypertension. Crit Care Nurse. 2019;39(4):e1\u2013e7."},{"issue":"5","key":"JPPT-25-00033-b09","series-title":"Crit Care Nurse","first-page":"32","article-title":"Safety recommendations for administering intravenous prostacyclins in the hospital","volume":"33","author":"Kingman","year":"2013","unstructured":"Kingman MSand Chin K. Safety recommendations for administering intravenous prostacyclins in the hospital. Crit Care Nurse. 2013;33(5):32\u201339."},{"issue":"5","key":"JPPT-25-00033-b01","series-title":"N Engl J Med","first-page":"296","article-title":"A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension","volume":"334","author":"Barst","year":"1996","unstructured":"Barst RJ, Rubin LJ, Long WA, et al. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med. 1996;334(5):296\u2013301."},{"issue":"6","key":"JPPT-25-00033-b02","series-title":"Circulation","first-page":"660","article-title":"Outcomes in children with idiopathic pulmonary arterial hypertension","volume":"110","author":"Yung","year":"2004","unstructured":"Yung D, Widlitz AC, Rosenzweig EB, et al. Outcomes in children with idiopathic pulmonary arterial hypertension. Circulation. 2004;110(6):660\u2013665."},{"issue":"21","key":"JPPT-25-00033-b03","series-title":"Circulation","first-page":"2037","article-title":"Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society","volume":"132","author":"Abman","year":"2015","unstructured":"Abman SH, Hansmann G, Archer SL, et al. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation. 2015;132(21):2037\u20132099."},{"issue":"8","key":"JPPT-25-00033-b04","series-title":"J Heart Lung Transplant","first-page":"841","article-title":"Prostacyclin administration errors in pulmonary arterial hypertension patients admitted to hospitals in the United States: a national survey","volume":"29","author":"Kingman","year":"2010","unstructured":"Kingman MS, Tankersley MA, Lombardi S, et al. Prostacyclin administration errors in pulmonary arterial hypertension patients admitted to hospitals in the United States: a national survey. J Heart Lung Transplant. 2010;29(8):841\u2013846."},{"issue":"11","key":"JPPT-25-00033-b05","series-title":"Am J Health Syst Pharm","first-page":"768","article-title":"Catastrophic circulatory collapse after inadvertent subcutaneous injection of treprostinil","volume":"75","author":"Radosevich","year":"2018","unstructured":"Radosevich JJ, Dutt M, and Feldman J. Catastrophic circulatory collapse after inadvertent subcutaneous injection of treprostinil. Am J Health Syst Pharm. 2018;75(11):768\u2013772."},{"article-title":"Research Triangle, NC: United Therapuetics","year":"2023","key":"JPPT-25-00033-b06","unstructured":"CADD-MS3 Ambulatory Infusion Pump (treprostinil) [Injection information]. Research Triangle, NC: United Therapuetics; 2023. 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Crit Care Nurse. 2019;39(4):e1\u2013e7."},{"issue":"5","key":"JPPT-25-00033-b09","series-title":"Crit Care Nurse","first-page":"32","article-title":"Safety recommendations for administering intravenous prostacyclins in the hospital","volume":"33","author":"Kingman","year":"2013","unstructured":"Kingman MSand Chin K. Safety recommendations for administering intravenous prostacyclins in the hospital. Crit Care Nurse. 2013;33(5):32\u201339."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/6\/article-p800.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/6\/article-p800.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/6\/article-p800.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T20:16:25Z","timestamp":1767125785000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/6\/article-p800.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":18,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.5863\/jppt-25-00033","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"type":"electronic","value":"2331-348X"},{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}