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
7.
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
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
19.
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
21.
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.
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.