Cost-effectiveness of infusion pumps to reduce errors in a Pediatric ICU

Abstract

Objective: To analyze cost-effectiveness and to calculate incremental cost-effectiveness ratio of the use of infusion pumps with drug library to reduce errors in intravenous drug administration in pediatric and neonatal patients in Intensive Care Units. Methods: Mathematical modeling for economic analysis of the decision tree type. The base case was composed of reference and alternative settings. The target population was neonates and pediatric patients hospitalized in Pediatric and Neonatal Intensive Care Units, comprising a cohort of 15,034 patients. The cost estimate was based on the bottom-up and top-down approaches. Results: The decision tree, after RollBack, showed that the infusion pump with drug library may be the best strategy to avoid errors in intravenous drugs administration. Conclusion: The analysis revealed that the conventional pump, although it has the lowest cost, also has lower effectiveness. RESUMOObjetivo: Analisar o custo-efetividade e calcular a razão de custo-efetividade incremental do uso de bombas de infusão com biblioteca de fármacos para reduzir erros na administração de medicamento pela via intravenosa, em pacientes pediátricos e neonatais em Unidades de Terapia Intensiva. Método: Modelagem matemática para análise econômica, do tipo árvore de decisão. O caso-base foi composto pelos cenários de referência e alternativo. A população alvo foram pacientes neonatos e pediátricos internados em Unidades de Terapia Intensiva pediátrica e neonatal, compondo uma coorte de 15.034 pacientes. A estimativa de custos foi baseada nas abordagens bottom-up e top-down. Resultados: A árvore de decisão, após RollBack, mostrou que a bomba de infusão com biblioteca de fármacos pode ser a melhor estratégia para evitar erros na administração de medicamentos intravenosos. Conclusão: A análise revelou que a bomba convencional, embora tenha o menor custo, tem também menor efetividade. Descritores: Enfermagem; Avaliação da Tecnologia Biomédica; Análise Custo-Benefício; Preparações Farmacêuticas; Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos. RESUMENObjetivo: Analizar el costo-efectividad y calcular la razón de costo-efectividad incremental del uso de bombas de infusión con una biblioteca de fármacos para reducir errores en la administración de medicamentos por vía intravenosa, en pacientes pediátricos y neonatales en unidades de terapia intensiva. Método: Modelaje matemático para el análisis económico, del tipo árbol de decisión. El caso base se compone de escenarios de referencia y alternativo. La población objetivo fueron pacientes neonatos y pediátricos internados en unidades de terapia intensiva pediátrica y neonatal, componiendo una cohorte de 15.034 pacientes. La estimación de costos se basó en los enfoques bottom-up y top-down. Resultados: El árbol de decisión, después de Roll Back, mostró que la bomba de infusión con biblioteca de fármacos puede ser la mejor estrategia para evitar errores en la administración de medicamentos intravenosos. Conclusión: El análisis reveló que la bomba conv...

Alarm fatigue in infusion pumps in the pediatric context: integrative review / Fadiga de alarmes em bombas de infusão no contexto pediátrico: revisão integrativa

“…As for the cost-effectiveness studies between the use of infusion pumps with drug libraries and conventional infusion pumps to reduce adverse events, it was shown that although the latter has the lowest cost, it also has less effectiveness. 13 The smart pumps infusion pump has software in which a drug library is installed. Connected to the Internet, this system runs scheduled and established applications, and promotes modes of analysis of the collected data.…”

Evolution of Intravenous Medication Errors and Preventive Systemic Defenses in Hospital Settings—A Narrative Review of Recent Evidence

“…lww.com/JPS/A612). The studies were conducted in the United States (n = 16), [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] the United Kingdom (n = 7), [63][64][65][66][67][68][69] Australia (n = 3), [70][71][72] Brazil (n = 3), [73][74][75] Spain (n = 3), [76][77][78] Mexico (n = 2), 79,80 Saudi Arabia (n = 2), 81,82 Singapore (n = 2), 83,84 Canada (n = 1), 85 China (n = 1), 86 France (n = 1), 87 Germany (n = 1), 88 Italy (n = 1), 89 Netherlands (n = 1), 90 and Switzerland FIGURE 2. Outline of the narrative review process, analysis of the included articles (n = 63), and comparison to our previous systematic reviews.…”

“…91 Some studies (n = 2) were carried out in multiple countries. 92,93 The studies were conducted in hospital settings without a specification of a specialty area (n = 10), 55,56,[61][62][63]66,73,76,82,90 adult ICU (n = 9), 49,50,52,69,75,[78][79][80]92 hospital pharmacy (n = 7), 47,51,[57][58][59][60]93 pediatric intensive care unit (n = 5), 65,68,72,74,77 pediatric hospital (n = 3), 54,64,71 emergency department (n = 2), 70,84 anesthesia department (n = 1), 87 cancer hospital (n = 1), 86 and pediatric emergency department (n = 1). 81 Some studies (n = 8) were carried out in simulated environments comprising an anesthesia setting (n = 2), 83,88 hospital setting (n = 2), 48,67 ICU (n = 1), 85 NICU (n = 1), ...…”

“…Implementation of smart infusion pumps allows savings by reducing the annual consumption of IV solutions measured in both units (18%) and liters (22.3%). Silva et al, 2019 74 A mathematical modeling for economic analysis to analyze cost-effectiveness.…”

Nurses' perceptions about the operationalization of the nursing process in an emergency room / Percepções de enfermeiros sobre a operacionalização do processo de enfermagem em um pronto-socorro

“…In these situations, the nurse's quick thinking and technical ability make all the difference when dealing with a patient with several injuries. 5 In this sense, to systematize the care given to patients in the emergency room, we have the Nursing Process (NP), which guides nurses' work, aiming to qualify it. 6 It is a methodological approach used by nurses to provide individualized care to users, whose use has a positive effect on the results of the care given to patients.…”