The impact of using an intravenous workflow management system (IVWMS) on cost and patient safety

Lin, Alex C.; Deng, Yihong; Thaibah, Hilal; Hingl, John; Penm, Jonathan; Ivey, Marianne F.; Thomas, Mark

doi:10.1016/j.ijmedinf.2018.04.004

Cited by 9 publications

(16 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This interpretation is supported by previous studies that have shown that TAWS reduced the frequency of selection errors or failures to use UPV vials. 22 , 35 Notably, the configuration of TAWS in our institution was not able to detect errors in drug brand (eg, different brands of bortezomib), so further refinements to the TAWS may increase the safety benefits further.…”

Section: Discussionmentioning

confidence: 94%

“… 5 Furthermore, manual compounding relies on human double checks, which are vulnerable to interruptions, miscommunication, and delays (eg, waiting for a team member to become available). 5-7 Human fallibility also remains a risk factor that can lead to errors (eg, misreading drug labels or syringe measurements or unnecessary costs (eg, failing to use a used partial vial before it expires 8 ). For example, research shows humans have misread syringes (by at least 1 syringe graduation) 4% of the time, 9 and adding a double check does not reliably detect accuracy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital

Fan

Yang

et al. 2022

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Interventions to improve the safety and efficiency of manual sterile compounding are needed. This study evaluated the impact of a technology-assisted workflow system (TAWS) on sterile compounding safety (checks, traceability, and error detection), and efficiency (task time). Methods Observations were conducted in an oncology pharmacy transitioning from a manual to a TAWS process for sterile compounding. Process maps were generated to compare manual and TAWS checks and traceability. The numbers and types of errors detected were collected, and task times were observed directly or via TAWS data logs. Results Analysis of safety outcomes showed that, depending on preparation type, 3 to 4 product checks occurred in the manual process, compared to 6 to 10 checks with TAWS use. TAWS checks (barcoding and gravimetric verification) produced better traceability (documentation). The rate of incorrect-drug errors decreased with technology-assisted compounding (from 0.4% [5 of 1,350 preparations] with the manual process to 0% [0 of 1,565 preparations] with TAWS use; P < 0.02). The TAWS increased detection of (1) errors in the amount of drug withdrawn from vials (manual vs TAWS, 0.4% [5/1,350] vs 1.2% [18/1565]; P < 0.02), and (2) errors in the amount of drug injected into the final container (manual vs TAWS, 0% [0/1,236] vs 0.9% [11/1,272]; P < 0.002). With regard to efficiency outcomes, TAWS use increased the mean mixing time (manual vs TAWS, 275 seconds vs 355 seconds; P < 0.001), had no significant impact on average visual checking time (manual vs TAWS, 21.4 seconds vs 21.6 seconds), and decreased average physical checking time (manual vs TAWS, 58.6 seconds vs 50.9 seconds; P < 0.001). Conclusion In comparison to manual sterile compounding, use of the TAWS improved safety through more frequent and rigorous checks, improved traceability (via superior documentation), and enhanced error detection. Results related to efficiency were mixed.

show abstract

Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital

Fan

Yang

et al. 2022

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Description Of Studies Exploring Systemic Defenses To Preven...mentioning

confidence: 99%

“…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), ...…”

Section: Description Of Studies Exploring Systemic Defenses To Preven...mentioning

confidence: 99%

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

Kuitunen,

Airaksinen,

Holmström

2024

J Patient Saf

View full text Add to dashboard Cite

Objectives Intravenous drug administration has been associated with severe medication errors in hospitals. The present narrative review is based on a systematic literature search, and aimed to describe the recent evolution in research on systemic causes and defenses in intravenous medication errors in hospitals. Methods This narrative review was based on Reason’s theory of systems-based risk management. A systematic literature search covering the period from June 2016 to October 2021 was conducted on Medline (Ovid). We used the search strategy and selection criteria developed for our previous systematic reviews. The included articles were analyzed and compared to our previous reviews. Results The updated search found 435 articles. Of the 63 included articles, 16 focused on systemic causes of intravenous medication errors, and 47 on systemic defenses. A high proportion (n = 24, 38%) of the studies were conducted in the United States or Canada. Most of the studies focused on drug administration (n = 21/63, 33%) and preparation (n = 19/63, 30%). Compared to our previous review of error causes, more studies (n = 5/16, 31%) utilized research designs with a prospective risk management approach. Within articles related to systemic defenses, smart infusion pumps remained most widely studied (n = 10/47, 21%), while those related to preparation technologies (n = 7/47, 15%) had increased. Conclusions This narrative review demonstrates a growing interest in systems-based risk management for intravenous drug therapy and in introducing new technology, particularly smart infusion pumps and preparation systems, as systemic defenses. When introducing new technologies, prospective assessment and continuous monitoring of emerging safety risks should be conducted.

show abstract

“…Multiple studies of IV workflow management system utilization have demonstrated a positive impact on patient safety, costs, and preparation time. [4][5][6] The sterile preparation center (SPC) at CCAD utilizes a standardized operating procedure for IV compounding and employs advanced technology, implemented through the integration of barcode-enabled workflows and an electronic verification system, whereby medication order routing, verification, preparation, checking, dispensing, tracking, and reporting are fully automated. The appendix summarizes the SPC workflow.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Workforce planning and safe workload in sterile compounding hospital pharmacy services

Chaker

Omair

Mohamed

et al. 2021

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose A prospective observational study was conducted to assess sterile compounding time and workforce requirements in a hospital pharmacy, resulting in development of staff benchmarking metrics. Methods The study was conducted in the IV room of a quaternary hospital over a total of 7 weeks. Compounding was directly observed and timing data collected for each compounded sterile preparation (CSP). The primary objective was to assess CSP workload, compounding time requirements, and workforce requirements to enable development of a data-driven staffing benchmark. Results A total of 320 sterile product preparations were directly observed during the study. Overall, the average time to compound 1 CSP (including small- and large-volume parenteral solutions, chemotherapy CSPs, batched CSPs, and syringes) was 3.25 minutes. Chemotherapy CSPs had the longest average preparation time (17.74 minutes); batched CSPs had the shortest preparation time, at 1.90 minutes per unit. A safe workload analysis indicated that in an 8-hour shift, 1 pharmacy technician can safely prepare 253 batched CSPs; 148 preparations of SVP solutions, LVP solutions, and syringes combined; 31 parenteral nutrition solutions prepared using an automated device; or 29 chemotherapy preparations. Through extrapolation of these results, it was calculated that a hospital with a capacity of 100 beds would require 1.4 pharmacist full-time equivalents (FTEs) and 2.7 technician FTEs to meet its sterile compounding needs, with proportionate increases in those estimates for a 300-bed hospital. Conclusion Organizations wishing to use external benchmarking information need to understand data characterization, pharmacy services offered, automation, workflows, and workload before utilizing that information for workforce planning.

show abstract

The impact of using an intravenous workflow management system (IVWMS) on cost and patient safety

Cited by 9 publications

References 3 publications

Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital

Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital

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

Workforce planning and safe workload in sterile compounding hospital pharmacy services

Contact Info

Product

Resources

About