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 youssawli@yahoo.com