Pharmacist-led, enterprise-wide intravenous immunoglobulin (IVIG) administration optimizations

Background In 2024, the study institution noted a trend of safety events involving intravenous immunoglobulin (IVIG). An audit revealed the majority of the events were identified during administration. The largest contributor to administration events was improper selection and use of weight during infusion pump programming. The objective of this study is to evaluate the impact of pharmacist-led interventions on dose–weight infusion pump programming during IVIG administration. Methods This single-center, quasi-experimental study included two groups of patients who received IVIG during an inpatient admission; a preintervention group that included patients between October 15th, 2024 and January 13th, 2025, and a postintervention group that included patients between March 25th, 2025 and June 3rd, 2025. Interventions targeted the electronic health record (EHR), infusion pump drug library, and nursing procedures. The primary outcome was the proportion of IVIG administrations with appropriate dose–weight infusion pump programming. Secondary outcomes included adverse drug reaction occurrence, reaction severity, epinephrine administration, and infusion completion. Results A total of 311 IVIG administrations were included for evaluation of the primary and secondary endpoints. In the postintervention group, a greater proportion of administrations achieved the primary endpoint (76.3% vs 65.3%; χ 2 = 4.166; P = 0.041). Adverse drug reaction occurrences (1.7% vs 4.7%) and epinephrine administrations (0% vs 1.0%) were decreased in the postintervention group. The rate of infusion completion was increased in the postintervention group (100% vs 98.4%). Conclusions Implementation of interventions to simplify and support appropriate IVIG administration improved the proportion of administrations utilizing appropriate dose–weight infusion pump programming.