Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.

Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.

The increasing number of occupational health and safety issues is a problem. Legislationsthat are anchored in European law, such as “machinery directive 2006/42/EC”, the “Use ofwork equipment 2009/104/EC” and the Swedish AFS 2001:1 (Systematic Work EnvironmentManagement) are defined but still lack the power to stop accidents/ incidents fromhappening. When risks are being made conscious they are not stopped by the legalrequirements in place. Scientific approaches such as the Swiss cheese model, safety management systems (SMS),and HTO (Human- Technology- Organization) explain how increased complexity inside asocio-technical system needs more attention. As the cases of accidents/ incidents in anoccupational setting still increase a need for solving this appears, with the help of sciencebasedtools. In cooperation with the company AFRY, I conducted four interviews (n=4) and analyzed twoABRA (activity-based risk assessments) already conducted by the company. Using thecommon themes identified from the interviews to analyze the ABRA helped to identify twokey problems: unclear communication and insufficient knowledge. With that in mind, I’m advocating for an increased emphasis on risk communication andresilience engineering. With the awareness that communication must be clearer and thatknowledge has to be increased, it is possible to work proactively on decreasing occupationalaccidents by mitigating the risks.