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change management medication administration

GoalsComponentsProcess ChangesClinical Staff Talking Points . Medication Administration. Goals. Medication Administration. Goals of Medication Administration. Increase Patient SafetyMultidisciplinary DocumentationContinuum of CareStandardized Practice. Evidenced-based research provides evidence of failure points in the current medication management processFour major sources of error at SentaraOrderingTranscription DispensingAdministration.

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change management medication administration

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    1. Change Management Medication Administration Kirby Stiening, eCare Implementation Lead, Pharmacy

    2. Medication Administration

    3. Medication Administration

    4. Goals of Medication Administration Increase Patient Safety Multidisciplinary Documentation Continuum of Care Standardized Practice

    5. Evidenced-based research provides evidence of failure points in the current medication management process Four major sources of error at Sentara Ordering Transcription Dispensing Administration Patient Safety

    7. Patient Safety Multiple Layers of Protection

    8. Multidisciplinary Documentation “Real time” documentation Documentation medications give by all disciplines in a single location Electronic chart accurately reflects all the types of medications that the patient has received concurrently

    9. Continuum of Care Documentation of medications administered in all phases of care appear on the same eMAR Medication Reconciliation is a separate process change that is not a part of this presentation

    10. Standardized Practice Variation = Opportunity for Error Provides a standard approach to support medication delivery and improve clinical outcomes. Double-check medication list and process for double-checks have been standardized across the system

    11. Medication Administration

    12. Components of Medication Administration

    13. Components of Medication Administration

    14. Components of Medication Administration

    15. Components of Medication Administration

    16. Components of Medication Administration

    17. Medication Administration

    18. Process Changes with Medication Administration Computerized Physician Order Management (CPOM) Entry of orders by Physician in electronic chart Eliminates transcription process Places alerts in front of Physician immediately Verbal Medication Order Entry by Nursing Nurses will enter verbal medication orders into eCare - RN will provide “Read-Back” to the Physician prior to order entry completion Document scanning - Onbase

    19. Process Changes with Medication Administration Alerts – Physician/Nursing/RT Still in active development At time of order entry Missing Allergies Allergy/Order alert Alerts – Pharmacy Dosage, Duplicate, Interaction Behind the scenes New allergy vs current orders Lab results vs current orders Pharmacy Verification

    20. Process Changes with Medication Administration

    21. Process Changes with Medication Administration Medication Schedule Adjustment by Nursing Documentation on eMAR/Documentation Flowsheets RNs/RTs document medications on the eMAR Other disciplines document medications on the eMAR and/or flowsheet Clinical staff can document assessments (pain, pulse, etc.) on MAR and they post to the appropriate flowsheet Medication Override Medications available on Pyxis override (without valid order) Will be linked to medication order once entered by pharmacy

    22. Process Changes with Medication Administration

    23. Process Changes with Medication Administration

    24. Process Changes with Medication Administration Barcode Scanning of Medications Clinician (nurse or other discipline within scope of practice) acknowledges medication order Clinician obtains medication from Pyxis or location listed on eMAR Clinician takes medication to patient’s bedside

    25. Process Changes with Medication Administration Clinician scans the patient’s armband this identifies patient & opens the chart Clinician scans all medications documents the medication as “given” double-check for right dose and form Patient “5 rights” confirmed Clinician scans her/his Sentara employee badge Clinician administers medication and monitors response

    26. Barcodes

    27. Symbologies

    28. Scanners

    29. Software

    30. Barcodes – the Pharmacy Challenge

    32. Summary of the Pharmacy Process

    33. Modified Nursing Processes

    34. Modified Nursing Processes

    35. Monitoring

    39. Medication Administration

    40. eCare Medication Administration Staff Talking Points Increased patient safety with barcode scanning of medications to Ensure “5 Rights” Continuum of care though all areas of hospital with all departments documenting medications administered on eMAR No (interface) documentation of medications given through Pyxis RN directly enters verbal medication orders in computer with physician “read back” RNs document IV rate changes on the flowsheet Some other disciplines can document medications on the flowsheet Nursing can make schedule adjustments Real time documentation with electronic chart accurately reflecting all types of medications that the patient has received Clinical staff can document assessments (pain, pulse, etc.) when documenting medication given on MAR that are automatically added to flowsheet

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