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Discussion

Changing to standardized drips?

Our NICU is considering changing to standardized concentrations for all of our drips. I think its a JCAHO thing. Has anyone done this yet? Currently we use the rule of 6's to calculate our drips. Any baby that is on 20mcg/kg/min of dopamine gets the same rate; the only difference is how many mg's of dopamine is in your syringe/bag. We want to switch so that all dopamine syringes are the same concentration mg/ml. We have to do this for all of our drips: insulin, fentanyl, versed, dobutamine, etc. Does anyone have recommendations for the concentrations that there NICU's use? I believe this is how drips work in the adult nursing world. Does anyone have any teaching tools or charts to help us with this process? This could be a difficult change over.:confused:

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    I don't know specifics, but we got rid of the all 6's rule years ago, when we went to the 'smart' syringe pumps which have the drips calculated and use standard drips that the pharmacy makes up. Of course, we always have two nurses double check the dosage and correct baby, etc, because problems do occur, but it does seem more straight forward than the all 6's rule did. imo

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    I was told we stopped doing that a few years ago and that it was a "joint commission" thing. I hate when I get told that because the majority of the time, it's not really, it's just something your management doesn't want to argue about.

    But I looked it up, and it really was a "joint commission" thing. Go figure!

    Anyway, it's not a really difficult thing to do when you have the smart pumps.

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