A REVIEW ON PATIENT-CONTROLLED ANALGESIA INFUSION SYSTEM

PCA is a patient-controlled analgesia infusion pump, which is used to infuse the medicine into the patients after surgery. It contains a syringe with pain medicine to infuse that is prescribed by the physician. The drugs used for pain control are high-alert medicines, since overmedication may cause death to the patients. These types of unbearable events may happen due to medical errors, prescription errors, adverse events (AEs), etc. Hence, it requires a precautionary attention or continuous monitoring for PCA pump infusion patients. However, always physicians or nurses may not monitor a patient continuously. To provide safety to the patient, the PCA pump needs a smart care process to alert the physician. This study represents the survey on PCA pump errors, AEs, and solutions for it to avoid them. The solution will automatically alert the infusion-related situation of the patients, those are taking the intravenous drug infusion at different procedure rooms in the hospitals. Moreover, it increases the safety to infusion pump with advances of decision-making in health, patient monitoring, alert notification to nursing, and productivity. This quality care can be achieved by integrating the PCA pump with other intelligent systems. Â

Efficacy of Smart Infusion Pumps from a Nursing Perspective

In today’s healthcare, intravenous (IV) therapy-related errors have become rampant and are responsible for a substantial portion of hospital injuries and deaths. In the last decade, however, since the development and implementation of “smart” IV pumps, a significant number of these IV medication errors have allegedly been reduced. The purpose of this paper is to discuss research surrounding an evaluation of the efficacy of smart IV pumps from a nursing perspective

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other A.S.P.E.N. publications, and researchers should consider studying the questions brought forth in this document

Android-based smartphone application simulation and systematic design to reduce medication administration error in prehospital emergency care.

Since 1999 when the report To Err is Human: Building a Safer Health System was released, medical errors have come into focus (Kohn, 2000). In an effort to reduce medication administration errors in prehospital emergency care, an android-based smartphone application simulation was created. The app has components including QR barcode scanning, text to speech for medication cross-checking, weight-based medication dose calculations, and time stamped medication data wirelessly transferring to a database in real-time. Color standard identification was implemented, aiding to a designed systematic process for patient treatment to reduce medication errors. Direct observation was performed of emergency patient calls with Richmond Ambulance Authority’s providers for a preliminary assessment. Device testing was assessed with emergency medical interns and functionally tested in different light environments. Results showed how similar different pharmaceutical vendors created medication labeling and that 58.3% of medical experts would say this device served to reduce medication administration errors

Usage of cardiotonic drugs at the intensive care units

Background: Circulation insufficiency is one of the most common dysfunctions in the patients admitted to the intensive care units (ICU) [1]. Thesepatients need an intravenous (IV) vasoactive drug administration to optimize or support cardiovascular system (CVS). Emergency situations, hard workconditions, difficult devices’ usage and a lot of other specific factors of complex environment of ICU create favorable conditions for the occurrence ofmedical errors (ME). Material and methods: Within this prospective study were examined the methods of administration and the types of the errors that were found duringthe administration of the following drugs: epinephrine, noradrenaline, dopamine and dobuthamine. In the period of time May – September 2016, wereexamined 50 patients from ICUs from 4 different hospitals. The age limits were between 31-100 years old. The data collection was accomplished on thebase of a questionnaire prepared beforehand. Results: From all the number of examined patients, 33 (66%) were men and 17 (34%) – women. The body weight was indicated in the medical notesof 21 (42%) patients. To 15 (30%) of them was administrated the adrenaline, noradrenaline had the incidence in 15 patients (30%) and dopamine –17 patients (34%). Conclusions: Tracked dosage errors in 20% of cases, 4% of them were found at dilution administration of the drugs. The inscription of administereddrug in medical notes was lacking in 2 uses

Praktische Aspekte der Arzneimittelsicherheit

Die Inzidenz von adverse drug events (ADE) in Spitälern und der Praxis ist hoch, beeinträchtigt Menschenleben und ist sehr kostspielig. Die Imple- mentierung von Massnahmen zur Feh- lerreduktion sind unbedingt notwen- dig, um Patienten sicherer behandeln zu können. Erfolgversprechend dabei sind die Schulung und der begleitende Einsatz von Fachkräften aus den Ge- bieten der Pharmazie, Pharmakologie und Toxikologie in Kombination mit technischen Lösungen wie der elektro- nischen Verschreibung, elektronischen Entscheidungshilfen und eindeutiger Identifikation von Arzneimitteln und aller am Medikationsprozess beteilig- ter Personen. Beim Einsatz technischer Hilfsmittel sind unbedingt die Arbeits- flüsse der beteiligten Gesundheitsbe- rufe zu berücksichtigen und wissen- schaftlich zu begleiten. Schlüsselwörter: Arzneimittelsicherheit – Patientensicherheit – elektronische Verschreibung – Behandlungsqualität. The incidence of adverse drug events (ADE) in hospitalized patients and ambulatory care is high. Next to human suffering they cause considerable additional cost and a prolonged length of stay. The reduction of ADE incidence is badly needed. Measures to reach this goal next to teaching are electronic prescribing tools with decision support, clinical pharmacists on ward rounds, therapeutic drug monitoring, smart infusion pumps and identification tools such as bar-coding and radio-frequency identification for patients, drugs and health professionals. Importantly, while integrating these technical tools, workflows of health professionals have to be considered and should be combined with a scientific analysis to uphold and ameliorate patient safety

Double checking the administration of medicines: what is the evidence? A systematic review

Objective To evaluate the evidence for double checking the administration of medicines. Design A systematic search of six electronic databases—Embase, Medline, British Nursing Index and Archive, CINAHL, National electronic library for Medicines (NeLM) and PsycINFO—for all articles describing double checking of medication and dose calculation, for either dispensing or administration in both adults and children up to and including October 2010. Results Sixteen articles met the inclusion criteria. There were only three quantitative studies. Only one of these was a randomised controlled clinical trial in a clinical setting. This study showed a statistically significant reduction in the medication error rate from 2.98 (95% CI 2.45 to 3.51) to 2.12 (95% CI 1.69 to 2.55) per 1000 medications administered with double checking. One study reported a reduction in dispensing errors, by a hospital pharmacy, from 9.8 to 6 per year following the introduction of double checking. The majority of the studies were qualitative and involved interviews, focus groups and questionnaires. Conclusion There is insufficient evidence to either support or refute the practice of double checking the administration of medicines. Clinical trials are needed to establish whether double checking medicines are effective in reducing medication errors

Barriers to the Use of Guardrails On IV Smart Pumps

Medication errors involving hospitalized patients have been an evolving challenge for decades. Moreover, errors related to intravenous (IV) medication administration continue to rise in hospitals despite implemented policies governing the use of Guardrails™ for safe IV medication infusion via smart pump technology. An organizational investigation was performed to identify barriers to the use of Guardrails™ among nursing staff. From 2015 through 2017, multiple interventions that aimed to identify barriers and increase nurses’ use of the safety features on IV smart pumps were implemented in the hopes of reaching a compliance goal of 90-100%. This quality improvement project assesses Guardrails™ compliance with smart pumps since its initial integration in 2010 and through 2017. A systematic organizational assessment was conducted at a Magnet®-recognized facility in South Carolina to identify the factors that influence the use of Guardrails™ by nurses, implement changes based on the assessment, measure outcomes, and make recommendations for future change to foster continued progress towards the 90-100% benchmark. Participants included all nurses who utilized the smart pumps with Guardrails™ (N=2,500). The results provided insights into the factors that either succeeded or not through collaboration with numerous stakeholders, metrics on Guardrails™ utilization, self-reported IV medication errors per year, and a pre- and post-project survey. The project offered valuable information that was used to implement changes that eventually resulted in an increase in nurses\u27 compliance with Guardrails™ use, provided recommendations for sustaining compliance, and proposed updates to the facility\u27s IV medication administration policy. The data results from the Guardrails™ compliance report and IV medication error rate between 2015 and 2017 provided enough evidence to suggest that a structured continuous education plan is essential to increase nurses’ awareness and adherence to policies and procedures governing the use of Guardrails™ on IV smart pumps