Abstract: Poster Presentations |


Elizabethann N. Cowboy, MD*; Robin Simmons, RN; Scott D. Nygaard, MD; Cheryl Donelan, RN; Shannon Miller, RN; Susan Hendrickson, RN
Author and Funding Information

Via Christi Health System, Wichita, KS


Chest. 2009;136(4_MeetingAbstracts):42S. doi:10.1378/chest.136.4_MeetingAbstracts.42S-a
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PURPOSE:  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.

METHODS:  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.

RESULTS:  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.

CONCLUSION:  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.

CLINICAL IMPLICATIONS:  Improving patient outcomes, increasing nursing satisfaction, and preventing avoidable drug errors depends upon appropriate use of people and technology.

DISCLOSURE:  Elizabethann Cowboy, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM




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