Wireless infusion pumps and patient safety
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Adopting wireless IV pumps and impact on patient safety
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Wireless infusion pumps and patient safety
- 1. Dr. Samir Sawli, CPHIMS certified
- 2. 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
- 3. 70-80’s 1990’s 2000’s 2010’s EMR Capability Basic Pumps (flow/time) with drug library Pump Smart pump (concentration limits) pumps with Server Smart, wireless Pump Interoperability
- 4. 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.
- 5. 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
- 6. 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
- 8. Infusion pump integration rests on five specific infrastructure requirements, which must be in place before a facility can move forward 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 data 5. and a highly reliable method of associating a pump channel with a patient and a medication
- 9. 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
- 10. 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
- 11. 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?
- 12. Medfusion® 4000 and PharmGuard® Software Suite PharmGuard® Server Software CQI reporting EMR Auto Charting to the EMR Auto programing from the EMR
- 13. 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
- 14. 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
- 15. 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
- 16. Provide a snapshot of overall medication safety trends, events and prevented medication safety errors Measures effectiveness against medication errors and patient safety
- 17. Pharmacy Smart to Improve Safety • Drug Program Compliance Reports • Safety Event Reports • Drug Program Utilization Reports • Device Event Reports © 2011 Smiths Medical. All rights reserved.
- 18. 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
- 20. MD ORDER CPOE/PAPER Alarms alerts get routed to Pharmacy nurse, Phar verification macy, CQI PATIENT Establish IV Verify the 5 Pharmacy rights Prepare Meds Administer drug Nurse Collect Med
- 22. 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%
- 23. 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.
Editor's Notes
- Goal: From Ben’s perspective…The benefits of wireless, and integration in the Middle East.How far has the technology advancedCurrent situation and the futureHighlight Smiths Medical’s innovationAudience: About 30 people in the room…Mixture of Doctors, Biomed, nurses
- The Medfusion® 4000 & PharmGuard® server system collects information that can then be used to create actionable and customizable reports. Each department in the hospital has the ability to collect the data from the Medfusion 4000 pump and analyze the data from their viewpoint…and then…Create actionable & customizable reportsThen use the reports to modify their drug library or update pump firmware, when appropriate.
- Pharmacy is able to:Track use of drug program library versus manual programming…. Drug Program Compliance Reports . Track hard and soft limits overrides and reprograms, hard limit override attempts (near misses) and abandons… Safety Event ReportsMonitor drug program utilization within libraries and each profile… Drug Program Utilization Reports Capture event history in order to trace infusion, clinical events and medication errors that were averted… Device Event Reports
- Set the alarm limit based on the acuity of the patient.Expectation is to cache the pump information during disruption of connectivity, and reconcile immediately once connected.