Transcription
Pharmacy and Emergency DepartmentOperations CouncilKenneth LongbrakeLorraineá Williams
Problem and Purpose Problem: Communication and collaboration betweenPharmacy and Emergency Department (ED) waslacking Purpose: Develop Pharmacy and ED OperationsCouncil to advance patient/medication safety andimprove communication
Background Patient visits: 120,000 annually Medication orders: 130,000 annually Medication orders written on paper and lackedpharmacist review ED nurses responsible for IV medication preparation No barcode administration system in the ED No tracking of medication safety outcomes
Methods November 2012: Pharmacy and ED Operations Councilestablished
Computerized Order Entry Improved patient safety Drug-drug interactions Weight-based dosechecking Medication profile reviewed Pharmacists worked withphysicians and nurses toensure the safe use ofmedications
Medication Order Verification
IV Medication PreparationOld Process: Nurse-PreparedAntibiotics Undiluted vial removed fromdispensing cabinet Vial diluted in med room or atbedside Dose drawn from vial andadministered via push or smartpump Nurse/nurse double-check Remaining dose wastedNew Process: Pharmacy-PreparedAntibiotics Use hospital standard dilutions/concentrations Dose prepared under sterile IV hood bytechnician/pharmacist Use DoseEdge system: Barcode product and dose verification Image capture of preparation processand final product Pharmacist verification of final product Remaining drug/dilution can be usedfor future doses
Barcoding MedicationAdministration Provides confirmation of: Patient identification Correct medication Dosage andconcentration Prescribed time
ED Medication Safety Dashboard
Conclusion Collaborative pharmacy and ED council resulted inreduction of reported medication events and patient harm. Implications of technology on pediatric medication safetyare profound. Successful outcomes can only be sustained withcontinuous collaboration of key stakeholders: multidisciplinary members of the pharmacy and ED operationscouncil.
Pharmacy and Emergency Department Operations CouncilKenneth Longbrake RN, BSN, CPEN and Lorrainea Williams Pharm.DCook Children's Medical Center, Fort Worth, TexasProblem Communication and collaboration between Pharmacy andEmergency Department (ED) was lacking.Purpose Develop Pharmacy and ED Operations Council toadvance patient/medication safety and improvecommunicationBackground/Significance Patient visits 120,000 annually Medication orders 130,000 annually Medication orders written on paper and lacked pharmacistreview ED nurses responsible for IV medication preparation No barcode administration system in the ED No tracking of medication safety outcomesComputerized Order EntryBarcoding Medication Administration Improved patient safety Drug-drug Interactions Weight-based dosechecking Medication profile reviewed Pharmacists work withphysicians and nurses toensure safe use ofmedications Provides confirmation of: Patient identification Correct medication Dosage and concentration Prescribed timeMedication Order VerificationED Medication Safety DashboardMethods November 2012 Pharmacy and ED Operations CouncilestablishedMedicationPrevious ProcessNew ProcessOrderingWritten on PaperComputerized PhysicianOrder Entry (CPOE)PharmacistreviewNoneElectronic Review and ing CabinetsProfiled Automated DispensingCabinets &ED Satellite PharmacyDocumented onPaperPatient and Medication BarcodeVerified and ElectronicDocumentationNoneED Medication Metrics DashboardAdministrationTracking keyindicatorsIV Medication PreparationOld Process:Nurse-Prepared Antibiotics Undiluted vial removed fromdispensing cabinet Vial diluted in med room or atbedside Dose drawn from vial andadministered via push or smartpump Nurse/nurse double-check Remaining dose wastedNew Process:Pharmacy-Prepared Antibiotics Use hospital standard dilutions/concentrations Dose prepared under sterile IV hood bytechnician/pharmacist Use DoseEdge system: Barcode product and dose verification Image capture of preparation process and finalproduct Pharmacist verification of final product Remaining drug/dilution can be used for futuredosesConclusion Collaborative pharmacy and ED council resulted in reductionof reported medication events and patient harm. Implications of technology on pediatric medication safety areprofound. Successful outcomes can only be sustained with continuouscollaboration of key stakeholders: multi-disciplinary membersof the pharmacy and ED operations council.
Pharmacy and Emergency Department Operations Council Kenneth Longbrake RN, BSN, CPEN and Lorrainea Williams Pharm.D Cook Children's Medical Center, Fort Worth, Texas Problem Computerized Order Entry Barcoding Medication Administration Communication and collaboration between Pharmacy and
