Development and validation of an intelligent weight verification management system for neonatal ready-to-use parenteral nutrition infusions

Abstract

Objective To develop an intelligent weight verification management system for the quality of ready-to-use neonatal parenteral nutrition (PN) infusions and validate its reliability and application efficacy, aiming to enhance the quality and safety of these infusions. Methods An intelligent weight verification approach was established through drug density determination, maintenance of information parameters, automatic calculation of theoretical weight by the hospital information system (HIS), and actual measurement using a high-precision electronic scale. A total of 350 bags of neonatal PN orders prepared in the Pharmacy Intravenous Admixture Services (PIVAS) of our hospital from January to June 2024 were randomly selected. Seven compounding technicians prepared 50 bags each, and two designated pharmacists conducted verification using the residual liquid method and the weighing method, respectively. The error rate between the theoretical and actual weighing values was computed, statistical analysis of the pertinent data was conducted, and the viability of the weighing method was assessed from four perspectives: precision, trend controllability, operator stability, and verification efficiency. Results The relative standard deviation (RSD) of error rates was < 1%, indicating excellent precision. The average error rate was 1.92%, with 97.43% of error rates within the predefined threshold (−1% to 5%) and 90.9% within the 3σ range. The error rate trends for different volumes aligned with variations in filling quantities, demonstrating controllable overall error trends. The interquartile range (IQR) variation in error rates among operators at different time points was < 30%, reflecting good operational stability. The weighing method achieved significantly higher verification efficiency (15.4 minutes per bag) than the residual liquid method (28.6 minutes per bag, P < 0.05) and identified an additional 6 unqualified infusions. Conclusion The weight verification system demonstrates validated reliability in improving quality assurance and operational efficiency for ready-to-use neonatal PN infusions in PIVAS settings, warranting clinical implementation.