PEDIATRIC CONTINUOUS INFUSION STANDARDS - Updated June 2026 - Standardize 4 Safety Initiative

Oct 22, 2026

PEDIATRIC CONTINUOUS INFUSION STANDARDS provide national, interprofessional guidance to standardize medication concentrations and related dosing to reduce IV medication errors, particularly during transitions of care. The initiative outlines coverage for pediatric continuous IV infusions, adult continuous IV medications, compounded oral liquid medications, doses for oral liquids, intravenous intermittent infusions, and PCA/epidural medications. Background traces development from a 2008 IV summit through FDA-supported work starting in 2015, followed by quality-improvement rationale and pediatric-specific principles.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages20

Reading Time50 min

AccessFree to download

WHY STANDARDIZE

PRINCIPLES FOR PEDIATRIC CONTINUOUS INFUSION STANDARDS

Safety first—use commercial when possible

Try to limit to one concentration when possible

Consider concentration relative to fluid status

Use more concentrated when possible

Consider operational dispensing aspects and steps including waste

PEDIATRIC CONTINUOUS INFUSION STANDARDS Updated: June 2026 STANDARDIZE 4 SAFETY INITIATIVE Standardize 4 Safety is the first national, interprofessional effort to standardize medication concentrations to reduce errors, especially during transitions of care. These national standards will cover: • Concentrations and dosing units for intravenous continuous medications for adult patients. • Concentrations for compounded oral liquid medications. • Concentrations and dosing units for intravenous continuous medications for pediatric patients. • Doses for oral liquid medications. • Concentrations for intravenous intermittent medications. • Concentrations for PCA and epidural medications. The Standardize 4 Safety initiative began in 2008 when a multistakeholder IV summit was held to address preventing patient harm and death from intravenous (IV) medication errors. Among the recommendations made by the participants was to establish national standards for IV medications in hospitals including standardized concentrations and dosing. In addition, it was recommended that the national standards be created in collaboration with the Food and Drug Administration (FDA), the pharmaceutical industry, and other stakeholders. Since the summit, establishing standardized concentrations has garnered strong support from ASHP members, the Joint Commission, the Institute for Safe Medical Practices (ISMP), and others. 1 2 3 4 In 2015 the FDA, through its Safe Use Initiative, awarded ASHP a grant to develop and implement national standardized concentrations for IV and oral liquid medications. The aims of the grant were to: (1) identify a nationwide expert interprofessional panel consisting of physicians, nurses, and pharmacists; (2) create standards for adult continuous IV infusions, compounded oral liquid medications, pediatric continuous IV infusions, doses for liquid medications, intravenous intermittent infusions, and PCA and epidural medications; (3) disseminate the standards and assess their adoption. 1 ASHP Best Practices: Position and guidance documents of ASHP. 2014. ASHP, Bethesda, Maryland. 2 Larsen GY, Parker HB, Cash [J. et.al. Standard](J. et.al. Standard) Drug Concentrations and Smart-Pump Technology Reduce Continuous-Medication-Infusion Errors in Pediatric Patients. Pediatrics 2005;116:e21–e25 . 3 Joint Commission. Preventing Pediatric Medication Errors. [https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-39-ped-med-errors-rev-final-4-14-21.pdf](https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-39-ped-med-errors-rev-final-4-14-21.pdf). (accessed March 15, 2024) 4 Shekelle PG, Wachter RM, Pronovost PJ, [et.al. An Updated Critical Analysis of the Evidence for Patient Safety Practices. Comparative Effectiveness Review No. 211](et.al. An Updated Critical Analysis of the Evidence for Patient Safety Practices. Comparative Effectiveness Review No. 211) . (Prepared by the Southern California-RAND Evidence-based Practice Center under Contract No. 290-2007-10062-I.) AHRQ Publication No. 13-E001-EF. Rockville, [MD: Agency for Healthcare Research and Quality. March 2013.](MD: Agency for Healthcare Research and Quality. March 2013. www.ahrq.gov/research/findings/evidence-based-reports/ptsafetyuptp.html)[ ](MD: Agency for Healthcare Research and Quality. March 2013. www.ahrq.gov/research/findings/evidence-based-reports/ptsafetyuptp.html)[www.ahrq.gov/research/findings/evidence-based-reports/ptsafetyuptp.html](MD: Agency for Healthcare Research and Quality. March 2013. www.ahrq.gov/research/findings/evidence-based-reports/ptsafetyuptp.html).(accessed September 20, 2020) [ashp.org/standardize4safety](ashp.org/standardize4safety) PEDIATRIC CONTINUOUS INFUSION STANDARDS WHY STANDARDIZE To Err is Human was published in 1999 and highlighted the harm to patients from healthcare error. In that report, medication er

FAQs

What is the goal of the Standardize 4 Safety initiative?

Standardize 4 Safety aims to standardize medication concentrations and dosing units to reduce IV medication errors, especially during transitions of care.

Which medication areas do the national standards cover?

The standards cover concentrations and dosing units for adult and pediatric IV continuous medications, concentrations for compounded oral liquid medications, doses for oral liquid medications, concentrations for IV intermittent medications, and concentrations for PCA and epidural medications.

How do the pediatric continuous infusion principles support safety?

The document emphasizes using commercial products when possible, limiting to one concentration when feasible, selecting concentrations relative to fluid status, using more concentrated options when possible, and considering operational dispensing steps including waste.

Oct 22, 2026

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