Integrating technology to improve medication administration.

Purpose. The development, implementation, and evaluation of an i.v. interoperability program to advance medication safety at the bedside are described. Summary. I.V. interoperability integrates intelligent infusion devices (IIDs), the barcode-assisted medication administration system, and the electr...

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Published in:American Journal of Health-System Pharmacy Vol. 68; no. 9; pp. 835 - 843
Main Authors: Prusch, Amanda E., Suess, Tina M., Paoletti, Richard D., Olin, Stephen T., Watts, Starann D.
Format: research tables/charts Journal Article
Published: Oxford University Press / USA 5/1/2011
Online Access:View this record in EBSCOhost
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      dt: 5/1/2011
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      pub: Oxford University Press / USA
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        atl: Integrating technology to improve medication administration.
      aug:
        au:
          Prusch, Amanda E.
          Suess, Tina M.
          Paoletti, Richard D.
          Olin, Stephen T.
          Watts, Starann D.
        affil: Medication Safety Specialist, Lancaster General Health, Lancaster, PA
      sug:
        subj:
          Infusion Pumps
          Medication Errors Prevention and Control
          Heparin Administration and Dosage
          Human
          Pharmacy Service
          Pilot Studies
          Program Development
          Pennsylvania
          Academic Medical Centers
          Data Analysis Software
          T-Tests
          Poisson Distribution
          Descriptive Statistics
          Confidence Intervals
          Guideline Adherence
          Outcomes (Health Care)
      ab: Purpose. The development, implementation, and evaluation of an i.v. interoperability program to advance medication safety at the bedside are described. Summary. I.V. interoperability integrates intelligent infusion devices (IIDs), the barcode-assisted medication administration system, and the electronic medication administration record system into a bar-code-driven workflow that populates provider-ordered, pharmacist-validated infusion parameters on IIDs. The purpose of this project was to improve medication safety through the integration of these technologies and decrease the potential for error during i.v. medication administration. Four key phases were essential to developing and implementing i.v. interoperability: (a) preparation, (b) i.v. interoperability pilot, (c) preliminary validation, and (d) expansion. The establishment of pharmacy involvement in i.v. interoperability resulted in two additional safety checks: pharmacist infusion rate oversight and nurse independent validation of the autoprogrammed rate. After instituting i.v. interoperability, monthly compliance to the telemetry drug library increased to a mean ± S.D. of 72.1% ± 2.1% from 56.5% ± 1.5%, and the medical- surgical nursing unit's drug library monthly compliance rate increased to 58.6% ± 2.9% from 34.1% ± 2.6% (p < 0.001 for both comparisons). The number of manual pump edits decreased with both telemetry and medical-surgical drug libraries, demonstrating a reduction from 56.9 ± 12.8 to 14.2 ± 3.9 and from 61.2 ± 15.4 to 14.7 ± 3.8, respectively (p < 0.001 for both comparisons). Through the integration and incorporation of pharmacist oversight for rate changes, the telemetry and medical-surgical patient care areas demonstrated a 32% reduction in reported monthly errors involving i.v. administration of heparin. Conclusion. By integrating two stand-alone technologies, i.v. interoperability was implemented to improve medication administration. Medication errors were reduced, nursing workflow was simplified, and pharmacists became involved in checking infusion rates of i.v. medications.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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