Judul : Quality-improvement analytics for intravenous infusion pumps

Abstract : Over the past decade, an increasing number of institutions have adopted smart-pump
technology to reduce errors and adverse events associated with i.v. infusions. Integrating decision-
support software and a customized drug library, this technology enables the nurse to receive and
respond to smart-pump alerts generated at the patient’s bedside, potentially intercepting harmful i.v.
infusion errors. Infusion programming data, including alerts generated and nurse responses, are stored
on the respective pump and (if wireless technology is available) on a central server. The regularly
scheduled re-
trieval and analysis of these data and distribution of the findings are key to driving the growth and
success of a smart-pump program. The absence of consistent feedback and subsequent interventions
and education can dilute the safety-enhancing benefits of the smart-pump device due to diminishing
program commitment and the eventual introduction of unchecked, potentially harmful pump
programming “workarounds.”

Disscusion : The use of programmable infusion smart pumps is included in the Joint Commission’s
National Patient Safety Goals,6 prompting facilities across the country to adopt smart-pump technology.
Thoughtful program design and systematic implementation of the CQI program have enabled the
maintenance and continued growth of a systemwide smart-pump initiative. We sustain an evidence-
based and clinically applicable drug library through meaningful interventions derived from scheduled
comprehensive analyses of smart-pump CQI data, reported ADEs, current scientific literature, and, most
important, the valued participation of our clinicians. Our models and extensive experience are shared
across the health system and are applicable to facilities regionally and nationally.Targeted educational
efforts and facilitation of i.v. medication dosing and concentrations have decreased variances from
recommended i.v. administration practices and improved GDR compliance systemwide. The smart-pump
technology is a successful vehicle for standardizing practices while allowing appropriate flexibility for
special patient populations. Small and large hospitals, as well as outpatient clinics, benefit from
implementing evidence-based standardized medication infusion practices and guidelines. Our CQI
program, including the structured quality metrics and report formats described here, can be adapted by
any facility. The lessons learned in reviewing i.v. medication ADEs and interpreting GDR alerts with the
use of our algorithm can assist facilities new to smart-pump integration.

Conclusion : A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication
administration. The ongoing refinement of the drug library through the development and
implementation of key interventions promotes the growth and sustain-ability of the smart-pump
initiative systemwide.

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