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Adopting wireless IV pumps and impact on patient safety
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Wireless IV Pumps and Patient Safety
Dr. Samir Sawli, CPHIMS certified
IV Pumps historically Prerequisite 5 factors, how to prepare Impact of wireless pumps on health care Benefit for patients Benefits for Nurses Benefits for Pharmacists and Executives For IT Professionals and Biomed CPOE Process Bar Code Medication Administration (BCMA) Points to consider Beyond the hospital walls HHC
Outline
Infusion Pump Advancements
Cap
abili
ty
EMR 70-80’s 2000’s 2010’s1990’s
Today, intelligent infusion pumps: Are networked
Have medication management software that includes hard and soft drug limits to promote safe administration of medications to the patients.
Send and receive data over the network, stores data in servers
Collect and transfer data for reports that can be used for analysis continuous quality improvement (CQI) initiatives.
The devices are now considered “computers” at the bedside.
IV Pumps Today
PATIENT SAFETY: Most medication errors occur during drug administration
Medication Errors occur when the administration 5 rights are not followed
The 2006 Institute of Medicine (IOM)1 Report entitled “Preventing Medication Errors” states that medication
errors cause harm to 1.5 million people each year. Traditional smart pumps has reached the upper limit
and was not able to protect the patient and provider Healthcare cost-reduction programs are increasingly
focusing on medication errors through CQI data collected from Wireless pumps
Why Put The Effort
Was found to decrease medication errors and promote patient safety
The new wireless system enhances the safety of the patient and the health care provider
Reduces hassles and errors associated with manual IV pump programming
Changes the role of a nurse from device programmer to critical thinker
Gives your institution a new level of detail in CQI data mining with the ability
Tracks administration compliance down to the individual employee
Will require adoption and acceptance of safety culture to succeed
Wireless IV Pumps
The fruit is CQI Reporting
Infusion pump integration rests on fivespecific infrastructure requirements, whichmust be in place before a facility can moveforward with any integration plans:
1. Reliable, pervasive, and secure wireless connectivity
2. Electronic medication orders containing all infusion parameters
3. High compliance with bedside barcode scanning for medication administration
4. Electronic repositories for administration data5. and a highly reliable method of associating a
pump channel with a patient and a medication
5 Prerequisites
Establish correct and consistent use of both bedside bar coding (e.g., barcode enabled point of care (BPOC) or bar code medication administration, (BCMA)) and electronic IV medication orders that hold all pieces of data required for an infusion to begin.
Facility must have some type of electronic IV medication order available for entry into the system. For example, electronic orders can either be created through CPOE or through a pharmacist entering an electronic order after verifying a non-electronic order from a physician.
Establish Medication Safety Task force and empower it with decision making
What Can We do to Prepare
Prepare the Pharmacy, drug libraries, standard concentrations, automated drug orders, start defining the soft limits and hard limits
Adopt an electronic medication prescribing or dispensing system
Prepare the IT infrastructure
Nursing readiness is essential by mapping the medication administration process and enhance it when possible
What Can We do to Prepare
Rights of Medication Administration 1. Right patient 2. Right medication 3. Right dose 4. Right route 5. Right time 6. Right documentation 7. Right reason 8. Right response How we can achieve this?
5 rights are now 8!
Medfusion® 4000 and PharmGuard® Software SuitePharmGuard® Server SoftwareThe Solution
EMR
CQI reporting
Auto Charting to the EMR
Auto programing from the EMR
Positive outcome with error free/errorless care
Less hospital stay avoiding complications of medication errors and extended hospital days
Confidence with care facility Less noise with alarms Patient receive a holistic care characterized
by collaboration of nurses, Physicians, Pharmacists and Technology
Benefits for Patients
Good bye for manual charting, integrated wireless medication administration process provide auto documentation of infused drugs
Less errors, less incident reports and less disciplinary actions
More time at the bedside Less steps in preparing
the pump … Achieve the 8 rights
Benefits for Nurses
Revolutionary improvement within the pharmacy department contributing to increased efficiency and cost effectiveness
Real time data about what is being infused volume left alerting to prepare new bag before it finishes
Better planning for medication supplies and less stat orders
Less incidents to investigate and resolve
For Pharmacists
Provide a snapshot of overall medication safety trends, events
and prevented medication safety errors Measures effectiveness against medication
errors and patient safety
Hospital Executives:
Clinical Reports Inform Clinical Decisions
© 2011 Smiths Medical. All rights reserved.
Pharmacy Smart to Improve Safety
• Drug Program Compliance Reports
• Safety Event Reports
• Drug Program Utilization Reports
• Device Event Reports
Distribution of firmware and upgrades is done centrally
Real-time location of each pump through REAL TIME LOCATING SERVICE (RTLS) technology
Real-time communication of device errors and the need to provide maintenance
For IT Professionals and Biomed
PATIENT
MD ORDER CPOE/PAPER
Pharmacy verification
Pharmacy Prepare Meds
Nurse Collect Med
Establish IVVerify the 5 rightsAdminister drug
Alarms alerts get routed to nurse, Pharmacy, CQI
Data Transformed to Information
ALARMS NOISE: set those alarm limits
Disruption of connectivity Downtime Training Culture of Patient Safety Overriding of soft limits it
may take up to 3 years to decrease the overrides to 15%
Points to Consider
The big challenge is put in front of vendors and IT professionals to make wireless integration work beyond the hospital walls
As in Home Health care scenarios where pumps may malfunction and no one knows about it.
Beyond the Walls
Thank [email protected]