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YAMAN KAAKEH, PHARM.D., BCPS, is Clinical Assistant Professor of Pharmacy Practice, Purdue University, West Lafayette, IN; at the time of this study she was Pharmacy Practice Resident, Department of Pharmacy Services, University of Michigan Health System (UMHS), Ann Arbor. HANNA PHAN, PHARM.D., is Pediatric Pharmacotherapy Fellow, College of Pharmacy, The Ohio State University, Columbus; at the time of this study she was Neonatal Intensive Care Unit Clinical/Staff Pharmacist, Department of Pharmacy Services, C. S. Mott Children’s Hospital, UMHS. BRIAN D. DESMET, PHARM.D., M.S., is Pharmacy Specialist, Henry Ford Hospital, Detroit, MI; at the time of this study he was Pharmacoeconomics and Outcomes Fellow, Department of Pharmacy Services, UMHS. DEBORAH A. PASKO, PHARM.D., is Adjunct Clinical Assistant Professor, College of Pharmacy; Clinical Coordinator, C. S. Mott Pharmacy; and Clinical Pharmacy Specialist, Pediatric Critical Care, UMHS. DENISE K. GLENN, B.S.PHARM., is Supervisor, C. S. Mott Pharmacy, Department of Pharmacy Services, UMHS. JAMES G. STEVENSON, PHARM.D., FASHP, is Director of Pharmacy Services, University of Michigan Hospitals and Health Centers, and Professor and Associate Dean for Clinical Sciences, College of Pharmacy, University of Michigan, Ann Arbor.

Address correspondence to Dr. Stevenson at the Department of Pharmacy Services, UH B2D301, Box 0008, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5008 (jimsteve{at}med.umich.edu).

Purpose. The sensitivity and specificity of enhanced photoemission spectroscopy (EPS) for performing an automated final check of compounded i.v. admixtures at a pediatric hospital pharmacy were studied. Methods. A tabletop EPS device was used to test samples of seven high-risk drug–diluent combinations compounded in the pharmacy; the drugs were vancomycin, lorazepam, morphine, insulin, hydromorphone, gentamicin, and epinephrine. Ten sets of samples were prepared for each drug. Typically, a sample set consisted of dilutions ranging from 10-fold above to 10-fold below the targeted concentration. Testing was performed twice weekly between November 2005 and March 2006. Results. The EPS device detected errors departing from the targeted concentration by 20% or more with a sensitivity of at least 95%. Specificity in distinguishing among test medications at targeted concentrations was 100%. The percentage of passing samples with intermediate concentrations varied among the drugs. Conclusion. A tabletop EPS device demonstrated acceptable sensitivity and specificity for validating the identity and concentrations of selected high-risk i.v. medications compounded for pediatric patients. The device may help prevent clinically important medication errors caused by inaccurate compounding. Index terms: Aminoglycosides; Antibiotics; Anxiolytics, sedatives and hypnotics; Concentration; Control, quality; Diluents; Epinephrine; Errors, medication; Gentamicin; Hydromorphone; Injections; Insulin; Insulins; Lorazepam; Morphine; Opiates; Pediatrics; Spectrometry; Stability; Storage; Sympathomimetic agents; Vancomycin