Analysis of infusion solutions using a multisensory approach consisting of Raman spectroscopy, refractometry, and UV/Vis spectroscopy to prevent medication errors

Abstract

Incorrect medication poses a significant risk to patient safety. Various control systems are on the market to prevent incorrect medication, but none of these systems monitor the actual chemical composition. The first step was to differentiate the applications where infusions are used and to assess where the effects of incorrectly administered infusions have the most consequences. On one hand, there are the oncology wards; on the other, there are the intensive care units (ICU). For the latter, the major challenge is the variety of compounds, including simple electrolyte solutions, very low-dose catecholamines, highly concentrated glucose solutions, and mixtures of carrier solutions, electrolytes, and other drugs. A sole analytical technique, if practicable, fast, and inexpensive, cannot provide a qualitative and quantitative solution for this challenge. The conceived solution combines different technical approaches, generally suitable as on-site techniques, and evaluated for this application. We present a study on various medications and concentrations using a combination of Raman spectroscopy, UV/Vis spectroscopy, and refractometry. For the ICU scenario, almost all medications could be identified. In the case of Raman-spectroscopy on cytostatic drugs, chemometric approaches were applied to enhance the qualitative and quantitative information value further. This approach enables infusions to be identified up to 99 % correctly based on a connected database containing 500 Raman spectra of different medications and concentrations. This study aims to increase safety in hospitals and to facilitate the work of hospital staff in intensive care units and for oncology patients. Another application is in pharmacies for quality control.