Hospitals across the nation and Institute for Healthcare Improvement focus on decreasing errors on high-risk IV drug therapies. The first priority is to prevent the error with the greatest potential for harm. Via Christi Health System invested $4.3 dollars in IV technology that contains medication libraries, standardization of concentrations and dosing limits to assure safe delivery of IV medication. A 90-day survey revealed that the drug library was enabled 35% of the time resulting in medication errors. Education and follow up increased compliance to 50% but additional use of technology was needed to prevent errors.
VCHS utilized their TeleICU team to provide a point-of-care solution. Observation of the drug library usage was initiated with approval of the CMO and Director of Quality & Patient Safety. Monitoring and intervention with mentoring provided whenever the IV pump was improperly set or disabled.
The first year of Smart IV pump revealed 50% compliance by bedside staff. Nurses reported the drug library to be time consuming and was easier to override it “to get the job done”. A patient received with infusion of large dose of insulin, luckily without complilcation. TeleICU, Clinical Service Line Directors and Clinical Quality and Safety developed eCare Review Tool©. This tool was used to identify compliance and to intervene immediately when a high-risk IV drug was used without the drug library in use; results forwarded to directorsevery 12 hours. Compliance after observations initiated remains 100% for 12 months. ICU nurses are advising all nurses on the use of the IV drug library on patients transferred from the Med/Surg areas to the ICUs.
The cost of IV drug-related injuries in hospitals conservatively estimated at $3.5 billion per year. VCHS has dramatically reduced the risk of a serious patient injury by using new IV drug technology. Staff concern of inconvenience was invalidated by education and proper usage.
Improving patient outcomes, increasing nursing satisfaction, and preventing avoidable drug errors depends upon appropriate use of people and technology.
Elizabethann Cowboy, No Financial Disclosure Information; No Product/Research Disclosure Information