Neonatal Epinephrine: Reducing Calculation Errors

Tuesday, 19 November 2013: 10:00 AM

Gaye Rotramel, MS, RN
LifeStart Program- St. Women's Center, St. John Medical Center, Tulsa, OK

Learning Objective 1: describe causes of medication erros.

Learning Objective 2: discuss the importance of innovations in clinical practice.



Background: Epinephrine calculation errors during neonatal resuscitation of low birth weight and very low birth weight babies can significantly affect outcomes in terms of mortality and morbidity. An extensive review of literature concluded that medication errors in the calculation of Epinephrine during resuscitation can occur when providers rely on memory, lack access to needed information, safety techniques or standardized procedures (Benner, Sheets, Uris, Malloch, Schwed, & Jamison, 2002; Karlsen, 2006).

Methodology: A quantitative quasi-experimental pilot research study measured the effectiveness of a researcher-designed Epi Chart©,  a pre-calculated intravenous and endotracheal Epinephrine dosage chart, specific to babies weighing less than three kilograms used during neonatal resuscitation. The study was a convenient sample of 86 healthcare professionals working in Labor and Delivery, Newborn Nursery, Neonatal Intensive Care, and the Postpartum Unit of a large tertiary center. Subjects were asked the same Epinephrine dosage calculation question. The experimental group used the Epi Chart© and the control group relied on memory for the question response. Correct responses were compared between the experimental and control groups.

Results: Chi-square test demonstrated the effectiveness of the researcher designed Epi Chart© in the accuracy of responses in Epinephrine doses in the experimental group at the 0.01 alpha level (99% statistical confidence). The experimental group who used the Epi Chart© had significantly more correct dosages than the control group (p-value <0.0001). 


Conclusion: Utilization of the researcher developed Epi Chart© will result in a reduction of medication errors during neonatal resuscitation

Future Plans: Replication of this study in different geographical areas.