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Objective To evaluate the introduction of locally configured standard concentration (StdC) intravenous drug infusions in critically ill children.Methods This two-year quality improvement retrospective cohort study (2018–20) examined post-implementation of 47 StdC drugs configured across three weight bands: <5 kg, 5–20 kg and >20 kg in a 26-bed, multispecialty paediatric intensive care unit. The main outcome measures were (1) adherence to StdC use (non-adherence defined as using a bespoke drug concentration), (2) attempts at dosing above the pre-set infusion rates, known as hard limit events (HLEs), (3) incidents related to infusions and (4) percentage of total fluid allowance available for nutrition.Results In total, 33 224 infusions were administered, with morphine, clonidine and milrinone representing 61%. Most of them (83.6%) were initiated in children in the lower weight bands. Adherence to StdCs was 96% and was similar across weight bands. A total of 204 498 pump programming events were examined, with 418 (0.2%) being HLEs. Only 21 HLEs (0.01%) were considered potentially clinically significant (defined as programming >2.5 times the maximum dose). Following investigation, 20/21 were found likely to be related to training episodes, rather than true errors. Twenty clinical incidents linked to StdC infusions were reported but none caused harm. The mean fluid allowance available for nutrition after accounting for StdC volumes was 38.8% in the <5 kg weight band, and 71% and 67.4% in the other two bands, respectively.Conclusions Configured StdCs are effective and safe across all weight bands and allow for partial provision of nutritional needs in fluid-restricted patients. The high adherence rate facilitated pharmacy supplying infusions as Ready-To-Administer (RTA).