the future of medication administration
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The Future of Medication Administration. Medication Administration via Depot Technology. Tyler McGrath Nursing 357. Objectives. Describe d epot technology Describe the materials involved Discuss how this technology works Discuss the advantages and disadvantages - PowerPoint PPT PresentationTRANSCRIPT
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The Future of Medication
Administration
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Medication Administration via
Depot Technology
Tyler McGrath
Nursing 357
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Objectives
• Describe depot technology
• Describe the materials involved
• Discuss how this technology works
• Discuss the advantages and disadvantages
• Describe the information systems
• Describe the competencies of depot technology
• Discuss the legal and ethical issues
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Depot Technology
• Depot is an injection
• Oil or Polymer
• Medication mixed
• Ease of use
• Subcutaneously(SubQ) or intramuscularly(IM)
(Corporation, 2008) (Berkowitz, 2009) intramuscularinjectionsim.blogspot.com
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Depot Technology
• Slow, steady entry into the blood stream
• Enables high concentrations with smaller amounts
• Low cost
• Involves minimal teaching
• Being studied for pain management
(Corporation, 2008) (Berkowitz, 2009)
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Hardware Used in a Depot Injection
• This depends on the injection
• IM - 20 gauge needle, 1 to 1 ½ inch
• SubQ – 25 - 30 gauge needle, ½ to 5/8 inch
• Biodegradable polymer
Unsettlingdown.wordpress.com
(Berkowitz, 2009)
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How Does This Polymer Technology Work?
• The medication in injected into the body
• A medication infused polymer solidifies
• Medication is released over days or months
• The polymers are biodegradable
(Berkowitz, 2009)
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Positives and Negatives of Depot Usage
Advantages• Increased compliances
• Continuous therapeutic levels of medication
• Clinics for administration
• Quality of life
• Decreased side-effects
Disadvantages • Discontinuation of
medications early
• Non-compliance
• Limited medications
(O’ceallaigh, 2001) (David, 2001)
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Information Systems Involved
• Clinical information system• Used for the medication administration • Captured in the electronic health record (EHR)• Spread through the system
Emeraldinsight.com
(McGonigle, 2014)
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Information Systems Summarized
• Clinical information systems• Driven by barcoded medication • Bar codes scan into the EHR• The EHR can communicate with multiple healthcare
providers • The healthcare providers are able to communicate back
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Competencies and Skills
• How to draw up a medication
• How to use the Z-track method
• Assessment of an allergic reaction
Via shutterstock.com
aklasiccommotion.wordpress.com
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Responsibilities of a Nurse Informaticist
• Set-up of information systems • Maximum communication• Provide a record keeping system • Less medication errors• Timed administration for medications that last longer
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Legal Issues and Ethics
• Removal in patients with a history of mental instability • To remove or not
• Birth control• Long term effects on
reproduction• “…critics have associated
administering medication in this form with coercive or forced treatment.” (O'ceallaigh, 2001)
Via Corevalues.com
Right
Wrong
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Summary of the Depot
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SEDASYS SystemLindsay Keeley
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SEDASYS System
• Computerized-assisted personalized sedation device
• Delivers the drug propofol
• How does it work?• IV infusion• Over sedation
(“SEDASYS,” 2014)
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Parts of the SEDASYS
Bedside Monitoring Unit
Procedure Room Unit
Display MonitorAutomated
Responsiveness Monitor Handset
(“Sedation,” 2014)
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Administration
• Allows non-anesthesia professionals to administer propofol• Colonoscopy• EGD
• Initiating propofol sedation
• Maintaining propofol sedation
(“SEDASYS,” 2014), (“Sedation,” 2014)
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Contraindications
Allergy to propofol
Allergy to egg products or soy products
Pregnant or lactating women
Full Stomach
(“SEDASYS,” 2014)
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Safety Precautions
• Lockout Timers and Dosing Limits• 3-minute maintenance rate increase lockout timer• 90 second PRN dose lockout time • To reduce accidental overdose
• Max initial dose of 75 mcg/kg/min• Maintenance rates increases limited by patient responsiveness
(“Sedation,” 2014)
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Safety Precautions
• Responsive Oxygen Delivery• Oxygen delivered to patient’s nose and mouth• amount of oxygen is automatically adjusted• Oxygen source must be connected to device
(“Sedation,” 2014)
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Safety Precautions
Yellow alarm
Red alarm that
takes no drug
action
Red alarm that
stops drug
delivery (“Sedation,” 2014)
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Studies
• Lower occurrences of hypoxemia
• 2.5% of patients were in deeper sedations than intended
• ISAP is working to prevent and decrease these occurrences
(“SEDASYS,” 2014)
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References
• SEDASYS Computer-Assisted Personalized Sedation System - P080009. (2014, August 7). In U.S. Food and Drug Administration. Retrieved October 7, 2014, from http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/recently-approveddevices/ucm353950.htm
• Sedation Redefined. (2014). In Sedays. Retrieved September 16, 2014, from http://www.sedasys.com/
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References
• David, A., & Adams, C. (2001, January 1). Depot antipsychotic medication in the treatment of patients with schizophrenia: (1) Meta-review; (2) Patient and nurse attitudes. Retrieved September 18, 2014, from http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0011/64658/FullReport-hta5340.pdf
• Corporation, D. (2008, January 1). SABER™ Depot Injection Technology. Retrieved September 18, 2014, from http://www.durect.com/pdf/saber_brochure_20080107.pdf
• O'ceallaigh, S., & Fahy, T. (2001, January 1). Psychiatric Bulletin. Retrieved September 18, 2014, from http://pb.rcpsych.org/content/25/12/481.full
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References
• Berkowitz, A., & Goddard, D. (2009). Novel Drug Delivery systems: Future Directions. Journal of Nueroscience Nursing, 41(2), 115-120. (2009, April 1).