The integration of smart pumps with an EHRs, and the use of auto-programming isn’t common place in healthcare, but it should be. I’ve only come across a couple of facilities that have done it “successfully”. In addition I’ve heard a couple of presentations on the subject matter; one at ASHP a couple of years ago and one at the unSUMMIT last year.
The video below talks about the integration of smart pumps with Cerner at WellSpan Health in New Jersey. Interesting stuff.
Smartpumps are anything but smart. They provide an extra layer of safety to intravenously administered medications to be sure, but they can only do what we tell them. We build the “drug dictionaries” against which all infusions are measured and we ask those administering the medications to abide by the rules associated with programming and using the pumps. Unfortunately that leaves a lot of room for human error and outright flagrant disregard for processes and procedures. I digress, that’s a different post altogether.
Assuming that the provider responsible for setting up the pump follows the rules, and that the medication is correctly prepared by the pharmacy, then we may assume that the smartpump certainly has the potential to prevent errors that may have otherwise been missed. There are plenty of anecdotal reports out there from hospitals where smartpumps have prevented some pretty significant dosage errors associated with opioids and insulin. Not all these errors would have resulted in patient harm, but it’s eye-opening nonetheless.
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Recently I’ve been in bit of a blogging slump. The world of technology suddenly appears a little less exciting. In fact, I find myself thinking of current technology as boring. I read lots of blog posts and articles that refer to new technologies as “revolutionary”, but I haven’t seen much revolutionary technology lately. In fact, most of the new technology is simply an iteration of the same theme; or worse, recycling of an old theme.
Consumer technology is clearly ahead of healthcare with the exception of scanning devices like MRIs, which are pretty cool when you stop to think about what they do. However, some of the most recently vaunted consumer technologies are devices aimed at information consumption like the iPad or devices designed to access data and social media while on the go, i.e. the new crop of smartphones. It’s not really new technology per se, but rather a new application of already available technology.
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I always find it interesting to see what brings people to my website and what they decided to read once they get here.
Most read posts over the past 7 days:
Top searchterm phrases used over the past 7 days:
I always find it interesting to see what brings someone to my website and what they decided to read once they get here.
Most read posts over the past 7 days:
Top searchterm phrases used over the past 7 days:
Bar code medication administration (BCMA) is nothing new, but remains a hot topic in healthcare nonetheless. Another topic that has generated significant interest in healthcare over the past couple of years is the use of smart pumps, which I have posted on before. Unfortunately for most hospitals the two remain independent of one another with no appreciable integration. The integration of smart pumps with BCMA was one topic of discussion at this years ASHP midyear. I attended a couple of presentations from healthcare systems that had successfully integrated information from their pharmacy information system (PhIS) directly into their smart pumps for use with their BCMA system. Like many other ideas presented at large conferences, the situation is the exception rather than the rule.
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The MRidium 3860+ from IRadimed is the first non-magnetic iv pump with integrated SpO2 monitoring designed specifically for use around MRI scanners. According to the manufacturer: “The new 3860+ offers significantly upgraded performance and features to the already proven MRidium MR IV pump product line. With the addition of a 10 key numeric input keypad and its wider pumping range of O.l mL/Hr to 1400 ml/Hr, the 3860+ series allows quick programming and broad fluid flow control. The drug library has been enhanced to allow user profiles to be stored and easily transferred via the SD memory card to other pumps. With the addition of the Masimo SET Sp02 monitoring and specialized fiber optic sensor, the 3860+ facilitates both safe sedation AND monitoring in one portable MR safe unit. Approved for use in 0.2 to 3 T Magnets. Features: Dose Rate Calculator, Bolus Dose Programming, Secondary Drug Delivery, Syringe Delivery, Adjustable Occlusion Pressure, KVO, SpO2 monitoring, and Alarm Settings, [and] CQI Data Ability w/Tracking Software which records up to 3000 Entries.” A couple of things that stand out, besides being able to use it around an MRI scanner, are the wide range of infusion rates and the ability to use standard 10 to 60 mL syringes with the MRidium Syringe Adapter IV Set (image shown). I’ve seen several pumps that limit users to 999 mL/hr, which can create an issue in certain circumstances. The ability to utilize syringes comes in handy for pediatrics; most pediatric infusions require an entirely different pump.
Pharmacists aren’t typically interested in infusion pumps, but they catch my eye from time to time since my involvement with the Alaris Smart Pump project at our facility.
One day last week I was driving home and happened by a school that doubles as a community swimming pool in the summer. The street had several large speed bumps, forcing me to move rather slowly. I’m usually irritated by speed bumps because they slow me down. This day, however, I was happy they were there because a little boy darted out in front of me. I drive a ¾ ton Ford f250 crew cab pick-up. It’s big and heavy. I have serious doubts that a child would stand much of a chance if they went head-to-head with my truck. Fortunately I was coasting along at a safe 10 MPH secondary to the speed bumps and easily came to a stop at a comfortable distance away. At that moment I was thankful for the safety feature built into the pavement on the road, i.e. the speed bumps.
Alaris System: “The Alaris® System by Cardinal Health is designed for infusions and patient monitoring. It helps protect the patient and clinician from consequences of medical errors and helps positively affect patient outcomes through continuous improvements in clinical practice. The point-of-care platform standardizes every type of infusion on a common user interface and adds respiratory monitoring and bar coding as needed. Also a state-of-the-art computer, it bridges the gap between IV and IT to help prevent harm and optimize care.”
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