This came through one of my Google Alerts this morning. Life Pulse Health Magazine: “Pearson Medical Technologies’ [PMT] … m:Print Version 3.9.1 has been updated to use Microsoft SQL Server 2012/2014 for more efficiency and advanced performance. Each packaging run can now automatically generate a unique lot number. Most importantly, Pearson Medical has added a … Read more
Not exactly pharmacy technology. However, SMART-IV involves integration of iv infusions with bar code scanning at the patient bedside. That’s kind of pharmacy related, in a sort of roundabout way.
Check the video below for a look at how the system works. The commentary is in Dutch, so if you don’t speak Dutch you might be in trouble. Regardless, you’ll get the basic idea anyway.
Dogma: belief or set of beliefs that is accepted by the members of a group without being questioned or doubted (Merriam-Webster)
I have opinions, lots of opinions. And like most, I believe my opinions are valid; it’s human nature. It’s not uncommon for me to find people within a group that agree and disagree with my opinions. However, once in a while I come across an entire group of people that stand in disagreement with my thoughts. That’s not crazy to imagine, but when that happens I’m forced to re-evaluate. Let’s face it, if everyone thinks I’m wrong, it’s possible that I am.
Such is the case with my thoughts on the use of technology and personnel in the i.v. room, which are on record at this site and are quite transparent. In a nutshell I believe that:
I previously wrote about a live webinar put on by ASHP – Improving Safety and Efficiency in the IV Room: Key Features of Automated Workflow Systems – on Wednesday, May 20 2015. The webinar was made up of three separate, 20 minute presentations:
It seems as though everyone has chemotherapy on the brain. The National Institute for Occupational Safety and Health (NIOSH) is in the process of updating their Alert on Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. NIOSH already released a new list of hazardous drugs late last year. The U.S. Pharmacopeial Convention (USP) is busy finalizing General Chapter <800> Hazardous Drugs – Handling in Healthcare Settings. And now, ASHP has published updated chemotherapy guidelines.(1)
A friend and colleague, Ray Vrabel, left a comment on my post from April 20th. I thought what Ray had to say was too good not to post. He raises some good points, which are worth more discussion. Ray is a sharp guy, and he and I have had some good conversations over the past … Read more
Medication trays – a.k.a. med trays, code trays/kits/boxes/bags, transport trays/kits/boxes/bags, intubation kits, C-section trays, anesthesia trays, and so on ad infinitum – are common in acute care pharmacies.  I’ve seen them in every variation you can imagine in every pharmacy I’ve ever been in.
Depending on the situation, med trays can contain a large number of injectable medications. For example: code trays may contain several different neuromuscular blockers like vecuronium, rocuronium, succinylcholine; pressors like epinephrine, norepinephrine, phenylephrine;  other code drugs like atropine, vasopressin; reversal agents like naloxone and neostigmine; antibiotics, etc, while a C-section tray may contain local anesthetics in various shapes and sizes (lidocaine with or without EPI, SDV or MDV, bupivacaine of various concentrations, etc). The list goes on. It’s pretty crazy.
“Although some hospitals have chosen to limit use of these systems [IV workflow technology] for focused areas like admixture of chemotherapy or high-alert drugs, there’s no telling when someone might accidentally introduce a high-alert drug when preparing other drug classes that wouldn’t ordinarily be scanned. Therefore, to be maximally effective, the system must be utilized for all compounded admixturesâ€. (ISMP)
A couple of weeks ago I wrote about the need to use bar-code scanning technology during compounded sterile product (CSPs) preparation. In my mind it’s a no-brainer. The i.v. room is a dangerous place, and no amount of “double checking†is going to change that.
The tragic death of a hospitalized patient in Oregon [1] has once again put a spotlight on pharmacy i.v. rooms. Unfortunately this isn’t the first i.v. error to harm, or kill a patient and I’m sad to say that it probably won’t be the last. We know that IVs present higher risks than most other medications and the literature presents abundant evidence of the prevalence of pharmacy compounding errors which result in patient harm or death.2-11
According to a 1997 article by Flynn, Pearson, and Baker: A five-hospital observational study on the accuracy of preparing small and large volume injectables, chemotherapy solutions, and parenteral nutrition showed a mean error rate of 9%, meaning almost 1 in 10 products was prepared incorrectly prior to dispensing.6
The inherent problem with compounded sterile products (CSPs) is that the efficacy of IV medication administration hinges on the integrity of dose preparation and labeling in the pharmacy. If an item is compounded incorrectly in the pharmacy, no amount of verification at the bedside will alter that. Other than looking at an IV bag or syringe to ensure that no gross particulate matter is present, without chemical analysis it is impossible to verify the contents. Occasionally a color change will acknowledge the addition of the correct additive – yellow multivitamins, red doxorubicin, and so on – but even then, the correct amount (volume/dosage) cannot be verified.
RxADMIX has been around for a while. I first mentioned it back in September of 2012 (Cool Pharmacy Technology – RxAdmix).
Mark and I initially had RxADMIX pegged for inclusion in our report, In the Clean Room, but after several failed attempts to reach the company for information we removed them from our list. That’s a real shame. I thought the company had gone under, but it it appears that RxADMIX is alive and well. I found the YouTube video below, posted on October 31 2014, a couple weeks ago. It looks like the company is doing a bit of new marketing.