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Evidence to Improve Care

Multiple Intravenous Infusions


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends standardizing the practice, design, and education related to the administration of multiple IV infusions to mitigate associated risks. Specifically, the Ontario Health Technology Advisory Committee recommends the adoption of the 12 interventions indicated by the HumanEra field evaluations relating to the:

    • setup and programming of multiple primary continuous infusions

    • identification of an infusion

    • management of dead volume

    • set-up of secondary intermittent infusions

    • administration of IV pump boluses

  • The Ontario Health Technology Advisory Committee recommends that Health Quality Ontario and HumanEra develop an implementation strategy to facilitate the adoption of these interventions by the health system and establish key performance indicators to evaluate adherence to safe practice.

Read the full OHTAC Recommendation report



Patients often need several intravenous (IV) infusions through infusion pump at one time. Every day in Ontario, at least 2,000 patients require more than one IV line. While we all expect and strive for effective and safe care, we know sometimes caregivers make mistakes when more than one IV infusion is given at a time, resulting in patient harm, including death. These mistakes happen all over the province, not in any one clinical unit, hospital, or region.


Health Quality Ontario Reviews Multiple Intravenous Infusions

Smart infusion pump technology is now available, but the technology alone cannot reduce the many risks associated with giving more than one IV infusions at once. Improving safety requires a thorough understanding of the whole system.


Multiple Intravenous Infusions. Phase 2a: Ontario Survey
May 2014 (PDF)


Multiple Intravenous Infusions. Phase 2b: Laboratory Study
May 2014 (PDF)


Related Resources

OHTAC Interim Recommendations: Multiple Intravenous Infusions Phase 1b
May 2012 (PDF)


Multiple Intravenous Infusions; Phase 1b: Practice and Training Scan
May 2012 (PDF)


Mitigating the Risks Associated with Multiple IV Infusions: Recommendations Based on A Field Study of Twelve Ontario Hospitals
June 2012


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The Ministry of Health and Long-Term Care endorses this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with this recommendation and encourages health care professionals to adhere to it.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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