# Evaluating and improving the accuracy of pediatric infusion dose using PDCA combined with HPLC: a quality improvement study from China

## TL;DR

This study shows how using PDCA and HPLC can improve the accuracy of drug doses in pediatric infusions, reducing errors and adverse reactions.

## Contribution

The novel contribution is applying PDCA cycle management combined with HPLC to enhance pediatric infusion accuracy in clinical settings.

## Key findings

- Qualified infusion rates improved significantly after PDCA intervention (from 86.59% to 96.10%).
- HPLC and PDCA together enhanced the accuracy and uniformity of drug preparations.
- Adverse reactions in pediatric patients may decrease with better dose accuracy.

## Abstract

Accurate formulation of an intravenous infusion is critical in ensuring its smooth implementation. However, in clinical practice, owing to the diverse reasons for drug preparation, some patients cannot obtain safe and accurate medications, especially in pediatric infusion rooms. Pediatric patients often experience adverse reactions as the dosage administered does not meet the requirements or exceeds the recommended dose.

Finished product infusion of potassium sodium dehydroandrographolide succinate (PSDS) was used as the study drug. Drug residue samples from the finished product infusion bags were collected randomly in the pediatric infusion room and clinical wards before (from October 2022 to December 2022) and after (from May 2023 to July 2023) the plan-do-check-action (PDCA) cycle intervention. High-performance liquid chromatography (HPLC) was used to determine the drug content. Comparisons of the changes in the proportion of the drug in the infusion were made based on the monitoring results.

After PDCA cycle intervention, the qualified rates of whole, non-whole, and overall infusions increased from 92.95%, 82.68%, and 86.59% to 97.56%, 95.12%, and 96.10% (P < 0.05), respectively. The accuracy and uniformity of the infusion preparations significantly improved.

The combination of HPLC and PDCA cycle management can effectively improve the quality of pediatric infusion preparations and enhance their effectiveness.

The online version contains supplementary material available at 10.1186/s40780-025-00457-y.