Search

Background: Serious and life-threatening adverse drug events are often attributed to intravenous medication administration errors. Although smart infusion pumps are increasingly being adopted by hospitals to prevent such errors, data are lacking on their effectiveness in clinical practice. Aim: To measure and characterise intravenous medication administration errors and their clinical significance before and after the implementation of smart infusion pumps. Method: In the pre-intervention period, an independent observer over 41 working days recorded the prescribing and administration details of infusions administered via the IMED Gemini Volumetric Infusion Pumps. 20 months after the introduction of the smart pumps - Alaris GP Volumetric Pump with Guardrails software - a repeat audit was conducted over 27 working days. Only infusions containing drugs that were to be incorporated into Guardrails (the medication-error- prevention software of the Alaris GP pump) were evaluated. The clinical significance of the identified errors was evaluated by 2 independent assessors (pharmacist and doctor) and rated as 'low', 'moderate', 'high' or 'extreme'. Results: In the pre-intervention period, 76 infusions (n = 432, 18%) had one or more errors compared to 25 infusions (n = 266, 9.4%) following the introduction of the smart pumps. Of the 165 infusions administered using Guardrails, only 6 infusions with errors (3.6%) were identified. When drugs were infused with the Alaris GP pumps without Guardrails, the number of errors post-intervention when compared with errors in the preintervention period were not statistically significant (p = 0.8). When Alaris GP pumps with Guardrails were used there were no errors of 'extreme' clinical significance and only 1 error of 'high' clinical significance compared to the pre-intervention period where 1 'extreme' and 30 errors with 'high' clinical significance were identified. Conclusion: Alaris GP pumps with Guardrails resulted in significant reductions in the number and clinical significance of intravenous medication administration errors. [ABSTRACT FROM AUTHOR]

Aim: To describe the implementation of pharmacist-initiated e-script transcription service (PETS) in a teaching hospital; to validate the service through process indicators; and to explore the views of stakeholders. Method: Following an initial trial, PETS was implemented in 7 medical and surgical units at Frankston Hospital. Data were collected on activities and discharge prescription errors. Stakeholders' satisfaction was measured using a Likert scale based survey and group interviews. Transcripts of group interviews were analysed by informal word-based techniques, noting words or synonyms used repeatedly to discover themes. Results: During the implementation phase (8 to 29 February 2008), a daily average of 15 prescriptions (112 items) were prepared by the PETS pharmacist, i.e 30 to 60% of weekday discharge prescriptions. The discharge prescription error/amendment rate was 0.06 per patient. 163 respondents (92%) were satisfied or very satisfied with PETS. As a result of 3 group interviews of 10 doctors, 10 nurses and 10 pharmacists, several areas for enhancement were identified and implemented. Conclusion: PETS has transitioned from trial to mainstream service, facilitating the discharge process and improving continuity of care. [ABSTRACT FROM AUTHOR]