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BWH is internationally known for its revolutionary system linking bar code verification, computerized physician order entry (CPOE), pharmacy and the medication administration record to improve patient safety. Now, a multidisciplinary team from across Partners HealthCare has authored a white paper detailing how to advance IV medication safety by connecting the final, stand-alone piece: smart infusion pumps.
“This is a roadmap on how to connect the smart pumps to CPOE, eMAR and the upcoming Acute Care Documentation system to close the medication safety loop,” said Bill Churchill, MS, RPh, executive director of Pharmacy Services, who was part of the committee.
Representatives from Biomedical Engineering, Nursing, Pharmacy and IS from across Partners, as part of a High Performance Medicine patient safety initiative, have been working together to determine how to wirelessly network the pumps bi-directionally, associate them with a particular patient and have medication administration data fed into the patient care documentation systems, including eMAR, Acute Care Documentation and Pharmacy. The report, “HPM2:2 Medication Administration – Infusion Pump Connectivity to Clinical Systems,” details software, hardware and network security needs.
“Pump programming errors are not solved by CPOE or EMAR; automating this programming step as much as possible can help eliminate these potentially harmful errors,” said Tejal Gandhi, MD, MPH, director of Patient Safety for the Partners network.
While BWH first is focusing on rolling out current safety features hospital-wide, such as eMAR, the guide on how to connect the pumps is now in place. “This is good for patient safety, and it’s the last piece of the medication safety loop to close to make everything connected,” said Anne Bane, MSN, RN, program director of Clinical Systems Innovations for Nursing.
With wirelessly connected pumps, the doses of IV medications ordered in CPOE would be verified by Pharmacy and then automatically updated in eMAR. A nurse would program the IV pump by scanning the drug and the patient’s wristband, and that individual patient’s medication order data would be sent to the IV pump across the wireless network in real time. The nurse would verify the data and start the pump, with patient-specific data feeding back to eMAR, Acute Care Documentation and Pharmacy.
Wireless networking also enables the drug library in each pump to be upgraded in near real-time so that staff can keep current with new practice changes; it also allows for real-time downloading of pump quality intervention data so that BWH can continually improve the safety of this critical process.
“All care providers will be armed with so much better data to monitor medication safety,” Churchill said.