Xiaolu Zhang,1,* Meixing Yan,2,* Xianfeng Qu,3,* Yang Li,2 Lu Liu,2 Chang Liu2 

1School of Medicine and Pharmacy, Ocean University of China, Qingdao, People’s Republic of China; 2Department of Pharmacy, Qingdao Women and Children’s Hospital, Qingdao, People’s Republic of China; 3Department of Pediatrics, Qingdao Women and Children’s Hospital, Qingdao, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Chang Liu, Department of Pharmacy, Qingdao Women and Children’s Hospital, Shibei District, Qingdao, Shandong, 266034, People’s Republic of China, Email lch1001@yeah.net

Background: Intravenous (IV) therapy is a common treatment but is associated with high rates of medication errors and adverse events, especially in children. In China, most public hospitals have halted adult outpatient IV services, but pediatric IV management remains a challenge. This study evaluates the effectiveness of medication safety officer (MSO)-based multidisciplinary management on managing IV fluids in children’s outpatient and emergency departments, aiming to reduce adverse drug reaction (ADR) and standardize IV infusion management.
Methods: Implementing MSO-based multidisciplinary management integrates multidisciplinary supervision, information system optimization, and fostering medication safety culture. We assessed its effectiveness by examining indicators such as the utilization of IV infusion, the unreasonable rate of IV infusion prescriptions, the incidence of IV infusion ADR and medication expenses among outpatient and emergency department patients.
Results: Although peak pediatric influenza and mycoplasma infections led to increased rates of IV fluids after liberalizing control of COVID-19 epidemic, there was a notable decrease in the percentage of antimicrobials in IV infusion (P < 0.001). More importantly, the unreasonable rate of IV infusion prescriptions and the incidence of ADR to IV infusion have significantly decreased, dropping from 7.72% and 0.04% to 4.45% and 0.01%, respectively (P < 0.001). Furthermore, both average cost of drugs and per capita cost of using IV drugs significantly decreased (P < 0.001).
Conclusion: The implementation of MSO-based multidisciplinary management can effectively improve the irrational use of IV fluids, reduce ADR and medical expenses in pediatric outpatient and emergency departments, to ensure children’s medication safety.

Keywords: MSO-based multidisciplinary management, outpatient and emergency, children, intravenous infusion, medication safety