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Medication Error Reduction (MER) with Graseby Pumps Raph Samuel 13 November, 2003. Medication Error Statistics. Represent the largest single cause of errors in hospitals Eighth leading cause of death Accounts for more than 7000 deaths annually in USA alone
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Medication Error Reduction(MER)withGraseby PumpsRaph Samuel13 November, 2003
Medication Error Statistics • Represent the largest single cause of errors in hospitals • Eighth leading cause of death • Accounts for more than 7000 deaths annually in USA alone • Estimated cost per incident £1600 + 5 day in hospital Figures from Institute of medicine (IOM)
Smiths Business Statement • Smiths Medical is committed and actively promoting a program to reduce the number and severity of medication errors through the use of Graseby infusion devices. We have added new software features to our existing product line that will help reduce the possibility of incorrectly programming an infusion device at the bedside.
Some areas to address • Excess manual operations on complex equipment • Drug Protocols, Good pump interface etc. • Staff competence assessment and training • Programming error log for analysis • Availability of information • Medical devices connectivity, Patient allergies etc. • Labelling of medication • Drugs look and sound similar • Patient identification • Right patient right medication
Graseby MER SolutionsExcess manual operation • Graseby Pump Drug Protocols: • Define the pump infusion program and Parameters: Infusion mode, Rate, KVO etc. • Prepared by ‘clinical experts’ • Used by ‘non experts’ • Reduces or even eliminates manual keystrokes to correctly start an infusion at POC • Hard and Soft Parameter Limits
Graseby MER SolutionsStaff Assessment and Training • Develop better system for monitoring and reporting adverse events (Reactive measures): • Programming error log with nurse and patient identity • Remote monitoring of multiple pumps • Remote alarms and events alerts • Event history log on pump • Real time remote history download
Graseby MER SolutionsAvailability of Information • Increase use of Information Technology : • High speed pump networking - TCP/IP • Wireless – 802.11 option • XML/HL7 communication protocol • Encryption • Use conventional computer & PDA • Interface to industry standard PDMS • Use Graseby proprietary PC Software for best data and protocol remote management
Graseby MER SolutionsLabelling of Medication • Use of machine-readable coding: • Use barcode on • Drug • Identifies and displays drug • Could be used to set up infusion parameters • Patient • Infusion Device • Clinician
Graseby MER Solutions • Proactive measures to cross-check that easily fits with existing systems: • Right Drug • Right Patient • Right Pump Settings • Right time of medication delivery
Graseby Pump Protocol Software Barcode Reader Network Comms. TCP/IP XML/HL7 Encryption Graseby MER SolutionsModular approach • Stand alone System:
Graseby MER SolutionsModular Approach Cont. • Locally Connected System: Graseby Pump Protocol Software Barcode Reader Input Device Network Comms. TCP/IP XML/HL7 Encryption Graseby Pump Monitoring and Management Software MEDSHIELD Display
Graseby MER SolutionsModular Approach Cont. • Hospital Networked System: Graseby Pump Protocol Software Barcode Reader Network Comms. TCP/IP XML/HL7 Encryption Patient Data Management Software e.g. Siemens
Graseby MER Future Progress What do we need to do now: • Establish close co-operation with societies such as SCATA • Define a Master Drug Library (MDL) • Establish a working arrangements with hospitals to try out different ideas in • Initially, non clinical environment • Eventually in clinical application