A data-driven initiative raises nurse engagement in smart pump safety improvement and helps create a continuous quality loop to strengthen patient safety and gain data-driven insights.
This article first appeared June 12, 2017 on PSQH: Public Safety & Quality Healthcare.
By Nicole Karchner, PharmD
The introduction of “smart pumps” 15 years ago began a new era in IV medication safety. Many of the medications infused directly into a patient’s bloodstream (sedatives, insulin, anticoagulants, opioids) pose a high risk of patient harm; in fact, IV medication errors are twice as likely to cause patient harm compared to medications delivered via other routes (American Society of Health-System Pharmacists, 2008). A simple mistake in programming a pump—pressing “603” instead of “6.3,” or “25,000” instead of “2,500”—can deliver a massive, even fatal, overdose. With smart pumps, if infusion programming exceeds hospital-established limits, the dose-error-reduction software (DERS) generates an alert that must be addressed before infusion can begin. By using the safety features on smart infusion pumps, nurses can help improve patient safety and avert the medication errors associated with the greatest risk of harm: IV administration errors at the point of care (Wilson & Sullivan, 2004; Williams & Maddox, 2005; Fields & Peterman, 2005; Maddox, Danello, Williams, & Fields, 2008).
In addition to providing DERS, smart pumps also automatically capture previously unavailable data on IV infusions. An advanced data-analytics applicationa allows staff to more readily view, report, and use these data to identify key areas for improvement, without the burden and expense of additional staff, software, or daily data management. Staff can take actionable items such as necessary revisions to the DERS drug library, use their expertise to make the needed changes, and then implement the revised dataset hospitalwide in a continuous quality feedback loop.
Orange Regional Medical Center (ORMC) in Middletown, New York, is a 383-bed, Joint Commission–accredited hospital and member of the Greater Hudson Valley Health System (GHVHS). ORMC implemented smart pumpsa in 2005, followed by computerized prescriber order entry (CPOE) and barcode medication administration (BCMA) in 2011; it began regular use of the smart pump data-analytics applicationb in 2015.
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