Are We Making Smart Pumps Smarter?

Background: Medication errors comprise a significant proportion of medical errors, and are abundant, costly, and associated with causing harm to patients via adverse drug events. The most serious medication errors often involve IV medications. Smart pumps were developed to improve patient safety by reducing medication errors. While some studies have found that smart pumps do not decrease medication errors, most have found they are effective to some degree. It is believed that routinely analyzing data on smart pump alerts, making corresponding adjustments in the drug libraries, and analyzing those adjustments can reduce alarm fatigue, which may then decrease medication errors by resulting in less smart pump users overriding the alerts and utilizing workarounds of smart pump safety features. Objective: The objective of this study is to assess if changes made to the Indiana University Health system smart pump drug library decreased nuisance alerts by comparing the actions taken in response to alerts before and after the changes were made. Methods: For a given change made to the Indiana University Health smart pump drug library on April 1, 2016, actions taken in response to alerts corresponding to that change three months prior to and three months after the change were analyzed. The primary outcome was the percent of total alerts that were overrides. Using data from the smart pumps, the number of overrides, reprograms, cancels, and total alerts for each drug in the first and second quarter were recorded. The percentage of total alerts that were overrides, the percentage of total alerts that were reprograms, and the ratio of overrides to reprograms for each quarter were calculated. Results: Analysis was conducted on 8 drugs: carboplatin, fentanyl PCA, hydromorphone PCA, morphine PCA, morphine PCA 10-24kg, morphine PCA \u3e40kg, naloxone, and octreotide. From the first quarter to the second quarter, the percent of overrides increased for 3 drugs, but for all 3, the number of overrides and total alerts decreased. Of the 5 drugs that had a decrease in the percent of overrides, 3 had an increase in the number of overrides and total alerts. Only 2 drugs had a decrease in the percent of overrides and the number of overrides and total alerts. Statistical significance was achieved only for hydromorphone PCA and morphine PCA. The difference between the first and second quarters in the all the measured outcomes varied between the drugs. Conclusions: Forming any definitive conclusions was difficult due to the results containing a significant amount of variation. The literature suggests methods to improve smart pump usage, and improve medication safety by extension. These methods are interfacing smart pumps with computerized physician order entry, clinical decision support systems, electronic medical record/electronic medication administration record, pharmacy information systems, bar-coded medication administration, and laboratory data, as well as improving smart pump safety features compliance through education of smart pump users, leadership support, including/consulting smart pump users in drug library design, and routinely using the event log data as a component of a continuous quality improvement program. These methods are all in line with the current, trending belief that the best method for preventing medication errors is making changes to the medication use system as a whole to correct underlying systems failures instead of addressing a single point, such a smart pump alerts

Vital Decisions

Presents findings from surveys conducted in 2001 and 2002. Looks at how Internet users make decisions about what online health information to trust. Includes a guide from the Medical Library Association about smart health-search strategies

Contributing to a “culture of safety” by increasing usage of the drug library on smart infusion pumps: A Quality Improvement Project

Background: Computerized infusion devices called smart infusion pumps or smart pumps are clinical tools capable of decreasing IV medication infusion calculation errors through the use of embedded drug libraries. These devices are now important tools contributing to a “culture of safety” defined by the Joint Commission. Reports from April 2015 indicated a 22% occurrence rate in which the devices were not correctly programmed before infusion. AIM Statement: The global aim of this quality improvement project was to improve usage of the IV pump drug library by ensuring medication is correctly labeled before infusion. The specific aim was to increase the IV pump drug library usage from 78% to 90% by July 24, 2015. Method: Kurt Lewin’s Change Theory was used as the theoretical framework to guide the project and usage of the IV pump drug library on a 30 bed surgical unit. A pre- intervention Likert style survey was conducted to identify barriers to library usage, determine level of confidence with the library, and understand nurses’ ability to find a medication in the library. Meetings with the Unit Practice Council (UPC) and educational huddles were conducted to discuss correct usage of the drug library. Based on pharmacy reports, the menu of drugs displayed in the pump was changed to reflect the top ten most frequently used medications. Post-intervention pharmacy reports were compared to baseline. Results: Data from the pre-intervention survey and staff meetings indicated a knowledge deficit in correct usage of the IV pump drug library and perceptions of time constraints and inability to find medication as barriers to its usage. Data post “pump push” indicated the usage of the drug library was 84.2%. Conclusions: Implementation of educational huddles and a “pump push” was anticipated to increase the percentage of IV pump drug library usage. Implications for the role of the Clinical Nurse Leader (CNL) are explored and discussed

TESTING LIBRARY FOR SMART DRIVING COMPANION APPLICATIONS

This publication describes systems and techniques for providing a testing library for smart driving companion applications. A smart driving companion application may be an application that executes at a mobile computing device, such as a smartphone, to project a graphical user interface (GUI) to the head unit of a vehicle, such as by projecting its GUI to a display device of an infotainment system of a car or truck. A developer may write a smart driving companion application that uses a smart driving companion library that is specific to smart driving companion applications. A developer of a smart driving companion application can use a testing library to test the use of such a smart driving companion library. The testing library may implement the internal logic of the methods and classes of the smart driving companion library, and the developer may use the testing library to test whether the application behaves correctly in response to user input and as the application moves through different states of the application’s lifecycle

Use of Smart Phone among Para-Professional Librarians in Olabisi Onabanjo University Library, Nigeria

This study attempted to investigate how para-professional librarians (Library Officers cadre and only Assistant Library Officers) in Olabisi Onabanjo University (O.O.U) Library, Nigeria used smart phone to embrace academic library services. A questionnaire and an interview schedule were used to collect data for the study. The data were analysed using descriptive statistics and Analysis of Variance (ANOVA). The study revealed that all the library paraprofessional staff had and used smart phones for personal, official and library services, but the use for library services and routines (across the items for library services) were on a lower side. The study further revealed that gender of para-professional librarians does not influence smart phone use amongst other findings. The study thus recommended provision of good telecommunication facilities, integration of full mobile library applications and services into academic library functions and services and training of library staff for effective deployment of phone use for library services amongst others. Keywords: Library Services, Mobile Phones Use, Nigerian Para-Professional Librarians, Smart Phone Use, Smart Phone Use for Library Services, New Media

Connected seeds and sensors: co-designing internet of things for sustainable smart cities with urban food-growing communities.

We present a case study of a participatory design project in the space of sustainable smart cities and Internet of Things. We describe our design process that led to the development of an interactive seed library that tells the stories of culturally diverse urban food growers, and networked environmental sensors from their gardens, as a way to support more sustainable food practices in the city. This paper contributes to an emerging body of empirical work within participatory design that seeks to involve citizens in the design of smart cities and Internet of Things, particularly in the context of marginalised and culturally diverse urban communities. It also contributes empirical work towards non-utilitarian approaches to sustainable smart cities through a discussion of designing for urban diversity and slowness

Harold Robert Smart Correspondence

Entries include brief biographical information, a typed biography, typed and handwritten letters of correspondence on Cornell University, Ithaca, New York, Sage School of Philosophy, stationery, and a biographical book review newspaper clipping with a photographic image of Smart

SMART LIBRARY: ANTARA KONTESTASI ATAU KOLABORASI DENGAN GOOGLE DALAM MENGHADAPI DIGITAL NATIVE

Google telah berhasil di dalam memenuhi beragam kebutuhan generasi Digital native, maka diperlukan sebuah perubahan yang dilakukan oleh perpustakaan. Perubahan tersebut dapat dilakukan dengan mengembangkan perpustakaan gaya baru, yakni perpustakaan pintar (Smart library). Smart library akan dirasa mampu dalam menghadirkan segala hal yang dibutuhkan oleh generasi digital native saat ini. Metode yang akan dipakai dalam penelitian ini adalah studi kepustakaan yang dilakukan dengan menganalisis data melalui kegiatan mengumpukanberbagai macam sumber yang relevan dengan topik yang sedang diteliti, seperti buku, jurnal ilmiah, prosiding, maupun artikel ilmiah lainnya. metode kepustakaan juga dapat dipahami sebagai suatu metode pengumpulan data pustaka, membaca, dan menyatat, serta mengolah bahan penelitian. Hasil dari penelitian ini adalah smart Google yang mengusung sebuah konsep baru dari perpustakaan, memberikan sebuah tawaran yang menarik kepada pemustaka. Anggapan pemustaka bahwa perpustakaan sebagai sebuah ruang fisik yang usang, dan tidak mampu menyaingi Google kini telah terbantahkan. Smart library yang merupakan perpustakaan pintar, dengan kemampuan yang pintar, akan mampu menciptakan manusia yang juga pintar. Smart library mengusung konsep dasar dengan berorientasi kepada kenyamanan pengguna, dengan open data repository, yang didukung oleh technological playground, serta berlokasi di lingkungan yang sustainable, akan mampu berkembang dan melayani pemustaka yang tidak hanya berasal dari generasi sekarang (digital native), akan tetapi juga generasi-generasi yang akan datang. Selain itu, smart library juga mempunyai dimensi dengan smart services, smart people, smart governance, dan smart place. Dimensi yang dimiliki smart library, akan mampu bersaing dengan Google sebagai pusat sumber daya informasi kontemporer. Kata Kunci:Perpustakaansmart librarygoogle

SMART LIBRARY - The Use of Smart Card to Patronize Library Facilities

The project, SMART LIBRARY - The use of Smart Card to Patronize Library Facilities is initiated due to the increasing interest in computerized library management system. This has introduced number of problems areas that need to be addressed so that reliable library system can be carried out. The project has been adopted from the concept of e-Wallet where the patron makes payment to the library without using the intermediary parties such as bank or financial institution. Facilities provided by library such as internet usage and photocopy machine need to be managed efficiently so that patrons will enjoy the services without having any difficulties. This paper discusses the functionality of smart card in library management system. It investigates how smart card that will be introduced as debit card to patrons help them towards hassle free environment. This paper also discusses the impact of smart card system to the library management in tracking the money collected from the library facilities such as photocopy machine and internet usage. The author has chosen Waterfall model and prototyping as development method. It includes research on smart card capabilities, project analysis, design and implementation, and system testing. In the end of the project, the system would be able to produce transaction record for every facilities used by the patron. This report is an alternative solution for the library management to project the library's future planning.

Managing smart campus and smart libraries: a look at challenges and the way forward for libraries in developing countries

The paper focused on the challenges faced in creating and managing smart libraries in developing countries. The highlight of the paper are an overview of smart campuses and smart libraries; the justification for smart campuses and smart libraries. The key points for driving a smart campus and smart libraries include deep understanding of smart technological architecture; availability of smart devices and availability of smart platforms; The related technologies for smart libraries in smart campus include but not limited to cloud computing, radio frequency identification (RFID), mobile technology applications, internet of things (IoT) and wireless technology. Several challenges were identified such as unavailability of digital infrastructure, low level of partnership drive, lack of ict skills among library and information science professionals, high cost of maintenance and shortage of smart librarians. Provision of digital infrastructures, engaging in sustainable partnership initiatives, training and re-training of library and information science professionals, organizing of in-house training for library and information science professionals, recruitment of smart librarians, adequate funding were recommended. Keywords: Smart libraries, smart campuses, developing countries, librarie