Reliable and Scalable Infusion System Integration with the Electronic Medical Record

Pettus, Daniel C.; Vanderveen, Tim; Canfield, Robert L.; Schad, Robert

doi:10.2345/0899-8205-51.2.120

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Interoperable infusion pumps have been shown to increase safety by reducing errors associated with manual programming [2–10]. We believe that the same safety benefits are applicable to PCA smart pumps by reducing manual steps in programming infusions and documenting data.…”

Section: Discussionmentioning

confidence: 85%

“…The findings of this study in a community hospital, using commercially available technology, support the generalizability of these results to other healthcare settings and may contribute to safer, more effective pain management. It is important to note that successful implementation of interoperability can be complex and expensive, present technological and cultural challenges, and require long-term investments in hospital infrastructure for EHR systems, smart pumps, safety software, and wireless capability [1, 2, 21, 22].…”

Section: Discussionmentioning

confidence: 99%

“…Although not included in this study, it may be informative to evaluate the impact of auto-documentation on clinician workflow efficiency [2, 3, 21, 29]. The number of steps to deliver and document infusions is different in a manual versus an interoperable environment, with potential impact on cognitive load and time availability for other aspects of patient care.…”

Section: Discussionmentioning

confidence: 99%

“…Interoperability between smart pumps and electronic health record (EHR) systems is transforming how intravenous (IV) infusions are documented and administered. Interoperability, also known as integration, refers to the bi-directional communication between the two systems, allowing for automatic programming of the infusion pump with the physician-ordered, pharmacy-reviewed infusion parameters sent directly from the EHR, while enabling automatic documentation in the EHR of time-stamped infusion data from the pump [1, 2].…”

Section: Introductionmentioning

confidence: 99%

“…Large-volume smart pump—EHR interoperability is established in clinical practice while patient-controlled analgesia (PCA) pump—EHR interoperability is a relatively new technology. Interoperability improves medication safety through several mechanisms, including association of the infusion pump with the patient order, reducing manual keystroke errors, and delivering infusions within the dose-error reduction software (DERS) limits [2–10]. The added safety with interoperability and the availability of several infusion platforms has led nearly 200 hospitals (approximately 4% of all hospitals in the United States) to implement this technology with their large-volume smart pumps [11].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Patient-Controlled Analgesia (PCA) Smart Pump-Electronic Health Record (EHR) Interoperability with Auto-Documentation on Chart Completion in a Community Hospital Setting

2019

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IntroductionComplete and accurate documentation of opioids administered by patient-controlled analgesia (PCA) pumps is critical for ensuring a high-quality medication record and an accurate conversion of the intravenous (IV) regimen to oral therapy. Incomplete charting of PCA usage through a manual process may be associated with fragmented documentation of delivered therapy affecting the completeness of the medical record and the IV to oral dose conversion. This study is the first to evaluate the association between auto-documentation of opioid administration provided by PCA smart pump—electronic health record (EHR) interoperability and the completion of PCA opioid administration charting tasks.MethodsThis retrospective cohort study was conducted at Lancaster General Hospital, Lancaster, Pennsylvania. Patients were assigned to pre-auto-documentation (n = 55) or post-auto-documentation groups (n = 58) based on whether they received PCA therapy prior to or after PCA-EHR interoperability was implemented. Charting of PCA therapy included documentation of the number of patient attempts, number of doses given, and total volume infused for both pre- and post-auto-documentation groups. In addition, total dose delivered was documented for the post-auto-documentation group. The overall chart-field completion rate was evaluated as the primary outcome. Individual chart completion percentages were assessed by stratified groups as secondary outcomes.ResultsPCA smart pump—EHR interoperability with auto-documentation was associated with an increase in overall chart-field completion rate from 69.9 to 97.0% (p < 0.001). Auto-documentation was also associated with an increase in fully completed charts from 38 to 91% (139.3% increase, p < 0.001) and reductions of incomplete records in each stratified group (p < 0.001).ConclusionsPCA smart pump—EHR interoperability with auto-documentation is associated with significant improvements in the completion of opioid administration chart-fields. Improved documentation of PCA administered opioids may have implications for the safety of opioid administration. Additional studies will be needed to assess the potential clinical impact of these results.FundingICU Medical, Inc.

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Section: Discussionmentioning

confidence: 85%