Sterile product compounding using an i.v. compounding workflow management system at a pediatric hospital

Moniz, Thomas; Chu, Stephen; Tom, Crystal; Lutz, Peter L.; Arnold, Alana; Gura, Kathleen M.; Patterson, Al

doi:10.2146/ajhp130649

Cited by 26 publications

(26 citation statements)

References 5 publications

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“… §§Moniz et al (2014). 44 Wrong volume of drug/diluent (detectable by previous practices), wrong drug volume (not detectable by previous practices) and wrong diluent volume (not detectable by previous practices) are combined in this table as wrong dose. ¶¶Nguyen et al (2014).…”

Section: Resultsmentioning

confidence: 99%

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Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings

et al. 2017

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ObjectiveTo examine published evidence on intravenous admixture preparation errors (IAPEs) in healthcare settings.MethodsSearches were conducted in three electronic databases (January 2005 to April 2017). Publications reporting rates of IAPEs and error types were reviewed and categorised into the following groups: component errors, dose/calculation errors, aseptic technique errors and composite errors. The methodological rigour of each study was assessed using the Hawker method.ResultsOf the 34 articles that met inclusion criteria, 28 reported the site of IAPEs: central pharmacies (n=8), nursing wards (n=14), both settings (n=4) and other sites (n=3). Using the Hawker criteria, 14% of the articles were of good quality, 74% were of fair quality and 12% were of poor quality. Error types and reported rates varied substantially, including wrong drug (~0% to 4.7%), wrong diluent solution (0% to 49.0%), wrong label (0% to 99.0%), wrong dose (0% to 32.6%), wrong concentration (0.3% to 88.6%), wrong diluent volume (0.06% to 49.0%) and inadequate aseptic technique (0% to 92.7%)%). Four studies directly compared incidence by preparation site and/or method, finding error incidence to be lower for doses prepared within a central pharmacy versus the nursing ward and lower for automated preparation versus manual preparation. Although eight studies (24%) reported ≥1 errors with the potential to cause patient harm, no study directly linked IAPE occurrences to specific adverse patient outcomes.ConclusionsThe available data suggest a need to continue to optimise the intravenous preparation process, focus on improving preparation workflow, design and implement preventive strategies, train staff on optimal admixture protocols and implement standardisation. Future research should focus on the development of consistent error subtype definitions, standardised reporting methodology and reliable, reproducible methods to track and link risk factors with the burden of harm associated with these errors.

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Section: Resultsmentioning

confidence: 99%

“… 52 The other studies defined aseptic technique errors either based on bacterial cultures 29 34 or report of syringes left uncapped during the preparation process. 44 …”

Section: Resultsmentioning

confidence: 99%

Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings

et al. 2017

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“…There was no significant difference in error rates between baseline and post-implementation period. 31 Wright and colleagues found 8.5% of total errors were introduced by the automated IV workflow system which is less that reported by Moniz et al 30,31 The differences in reported error rates are likely due to variations in study design and definition of errors. Given the lack of standardized study design and measured outcomes, the impact of these systems cannot be assessed across multiple studies.…”

Section: Intravenous Automated Workflow Systemsmentioning

confidence: 87%

“…The initial studies of automated IV workflow systems were observational and identified errors captured with this new technology. [28][29][30] Wright and colleagues compared error rates between a manual IV preparation process and an automated IV workflow system with bar code verification and image capture. Baseline error data were collected over 4 days and compared with a 48-week post-implementation period.…”

Section: Intravenous Automated Workflow Systemsmentioning

confidence: 99%

Critical Evaluation of Pharmacy Automation and Robotic Systems: A Call to Action

Boyd

Chaffee

2018

Hosp Pharm

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“…Moniz et al implemented a BCMP system in their hospital pharmacy and collected data regarding the number of doses prepared in the pharmacy, the number of errors detected by pharmacists, and the number of reworked or rejected doses . The time of data collection was 5 months.…”

Section: Reducing Errorsmentioning

confidence: 99%

Technology in Parenteral Nutrition Compounding

Curtis¹

2018

Nut in Clin Prac

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Technology is constantly being used in novel ways, and its use in the practice of medicine is no exception. Examples of this include computer physician order entry, barcode-medication scanning, electronic health records (EHRs), and bedside patient charts, to name a few. Compounding parenteral nutrition has been included in this technological revolution, with improvements such as barcode-assisted medication preparation systems and EHR-to-compounder interfaces. Along with some of these electronic advancements come the inevitable improvements and challenges, which are explored in this article.

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Sterile product compounding using an i.v. compounding workflow management system at a pediatric hospital

Abstract: Implementation of an i.v. workflow management system that integrates barcode verification, automated calculations, and image-capture capabilities led to increased detection of errors in the sterile product compounding process.

Cited by 26 publications

References 5 publications

Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings

Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings

Critical Evaluation of Pharmacy Automation and Robotic Systems: A Call to Action

Technology in Parenteral Nutrition Compounding

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