In 2005 Kaleida Health, a nonprofit health care system, selected new smart pump technology for its five inpatient hospitals. However, the pharmacy department of Women and Children’s Hospital of Buffalo (WCHOB), a Kaleida Health facility, discovered the new technology did not meet the needs of its diverse patient population. Empowered by its hospital administration, the pharmacy department recruited a multidisciplinary team to develop an intravenous (IV) medication delivery system and intensive training program that would ensure the safe delivery of IV medications to WCHOB’s pediatric and adult populations.
This IV medication delivery system needed to ensure the ability to adjust to diverse patient needs; include a comprehensive, customized drug library; and use wireless technology to provide real-time updates and data for continuous quality improvement . An extensive education and training for nurses and pharmacists was a key element of the operational plan.
The team relied on evidence-based references; consulted with members of the Pharmacy and Therapeutics Committee, including a clinical toxicologist, for guidance on developing hard-limit alerts for medications; and sought input from front-line practitioners and engaged them in pre-implementation testing to develop a customized drug library, which includes more than 300 medication entries.
The comprehensive educational and training program, the accompanying policies and procedures and the user-friendly design of the IV medication delivery system resulted in 99-percent compliance and use of the system. This was a 60-percent increase compared to the rest of the health system. During the first year post-implementation, data from edits of hard- and soft-limit alerts demonstrated that errors were prevented. As the drug library was refined, preventable errors decreased by 50 percent and sustainability was demonstrated by constant drug library compliance in the ensuing 6 months.
This IV medication delivery system has been successful in preventing and reducing medication errors and provides insight as to how medications are being used. This initiative showcases the vital role that pharmacists, nurses and physicians have in ensuring that new technology is designed to optimize safe medication administration, protecting our most vulnerable patients.
Multidisciplinary Team
Cynthia Brown, R.Ph.
Pete Castronova BSEET
Michael Cimino, R.Ph., M.S.
Prashant Joshi, M.D.
Michael Kalita R.Ph., M.B.A.
Sandra McDougal, R.N., M.S.N.
Kelly Michienzi, Pharm.D.
Nadine Streleski-Flanders, B.S.N.
Nadine Tricoli-Billingsley, B.S.N.
Patricia Volker, R.N.
Mark Wujek, CBET, AAS