Guardrails® Safety Services Medication Safety Team Guardrails Dataset Development

GDD

Guardrails® Safety Services Medication Safety Team Guardrails Dataset Development

Addressing the Issue of Medication Errors

Medication errors place an enormous burden on health care systems both in human and financial terms. Research has shown that medication errors are a leading cause of medical injury in hospitals1,2. The direct cost of adverse drug events to public hospitals in Australia has been conservatively estimated to be more than 350 million dollars per annum3. The actual cost is likely to be much higher as the problem is vastly under-reported4,5 and the measured costs only account for the cost associated with increased length of stay. In human terms, up to 14,000 deaths per year are associated with a potentially preventable adverse event6, with medication incidents being the second most common type of incident reported in Australian hospitals7. Intravenous (IV) medications represent the most serious and costly medication errors8,9. While many of these medication administration errors are preventable, they are rarely intercepted before reaching the patient9,10. Selecting safety software that protects you and your patients at every infusion is critical to help prevent adverse outcomes. CareFusion has developed an advanced ‘smart pump’ solution called Guardrails Medication Safety to capture IV medication errors before they reach the patient. Guardrails Medication Safety software is imbedded in the infusion pumps and provides a ‘test of reasonableness’ at the point of care each time a drug administration is initiated or adjusted, giving the patient protection against receiving the wrong dose or rate.

Guardrails® Safety Services Medication Safety Team Guardrails Dataset Development Guardrails Medication Safety Software Guardrails Medication Safety software is a solution that is designed to reduce the number of medication errors that reach the patient. The software allows the hospital to configure best practice administration parameters for IV infusions across the wider hospital and medical community. The software in the pump then provides a ‘test of reasonableness’ at the point of care for each drug dose that is programmed into the pump. When an infusion is entered that is outside your hospital’s limits, an alert is immediately provided to the user identifying the dosing parameters that are outside of existing guidelines. By doing this, the ‘smart’ infusion pump prohibits the delivery of potentially dangerous doses of medication. The Guardrails alerts are recorded in the pumps’ CQI logs for later analysis with the Guardrails Continuous Quality Improvement (CQI) software. The Guardrails® Editor software allows an institution to define infusion parameters for multiple clinical care areas. These clinical care areas are referred to as profiles. Within a profile, multiple drug setups can be defined. Drug set up parameters include: oo oo oo oo oo oo

Drug concentrations Minimum and maximum concentration limits Dosing units Minimum and maximum dose limits Hard and soft alert settings Bolus alert settings

The Guardrails Editor application is a flexible and comprehensive tool for developing customised datasets. This helps ensure that datasets are simple to create, and can be easily reviewed or audited before and after upload into the smart infusion pumps.

Guardrails Safety Services CareFusion offers a comprehensive Safety Service including full project management and clinical consulting for Guardrails Medication Safety software. A customised project plan is provided to meet the hospital’s needs for Pump Implementations, Dataset Development, CQI Analysis, and Dataset Review. A highly qualified CareFusion Medication Safety Specialist is dedicated to each customer to assist with all project milestones. The CareFusion Medication Safety Team has extensive implementation and support experience in the IV medical technology industry, helping you to gain the full benefit of your IV device investment.

Guardrails® Safety Services Medication Safety Team Guardrails Dataset Development

The implementation of IV medication delivery systems impacts every patient care area and many clinical disciplines within the hospital. To ensure that the process is completed with minimum impact on the day-to-day operations of the hospital, the CareFusion Medication Safety Team is well organised and prepared to help manage the implementation within a mutually agreed timeframe.

This service includes: Project Management Support Together with the Hospital Project Leader, CareFusion personnel are responsible for developing and maintaining the project plan and ensuring that major milestones are met. Dataset Development Support The CareFusion Medication Safety Specialist facilitates the development of customised datasets and provides training on the Guardrails Editor software application. Clinical Support The CareFusion Clinical Nurse Educator provides comprehensive end user education around the customised dataset and manages the transition from current IV pumps to the CareFusion system with Guardrails Medication Safety software.

Guardrails Dataset Development Service Dataset Development includes: • Timeline of 12-16 weeks provided • Loan laptop supplied for the purposes of Dataset Development • Loan pump for the purpose of dataset consolidation and Clinical Review • IV needs analysis - review of protocols and clinical practice for IV drug delivery • Dataset Development key stakeholder meeting • Dataset Editor introduction day • Progress review meetings (via web connection if required) • Pump Configuration meeting • 2 x Dataset Clinical Review meetings • Dataset uploaded to Hospital pumps prior to shipping • Allocation of a Medication Safety Specialist for entire project timeline Loan pumps subject to availability

For further information or to discuss your hospital’s needs, please contact one of our CareFusion Representatives: CareFusion Australia Unit 3, 167 Prospect Highway Seven Hills NSW 2147 Australia Ph: 1800 833 372

CareFusion New Zealand 14B George Bourke Drive Mt. Wellington Auckland 1060 New Zealand Ph: 0508 422 734

References 1. Leap LL, Brennan TA, Laird N, Lathers AG, Localio AR, Barnes BA. “The nature of adverse events in hospitalized patients: results of the Harvard Medical School Practice.” NEJM. 1991;324:377-84. 2. Hargraves J. “Reporting of adverse events in routinely collected data sets in Australia.” Australian Institute of Health and Welfare, Health Division Working Paper No. 3, 2001. 3. Malpass A, Helps SC, Runciman WB. “An analysis of Australian adverse drug events.” J Qual Clin Practice. 1999;19:27-30. 4. Cullen DJ, Bates DW, Small SD, Cooper JB, Nemeskal AR, Leape LL. “The incident reporting system does not detect adverse drug events: a problem for quality improvement.” Jt Comm J Qual Improv. 1995;21(10):541-8. 5. Silas R, Tibballs J. “Adverse events and comparison of systematic and voluntary reporting from a paediatric intensive care unit.” Qual Saf Health Care. 2010;19:568-571. 6. Runciman WB, Moller J. “Iatrogenic injury in Australia.” Australian Patient Safety Foundation, ISBN 0-646-41132-2, August 2001. 7. Roughead EE, Semple SJ. “Medication safety in acute care in Australia: where are we now? Part 1: a review of the extent and causes of medication problems 2002-2008.” Aust New Zealand Health Policy. 2009;6:18. 8. Keohane CA, Hayes J, Saniuk C, Rothschild JM, Bates DW. “Intravenous Medication Safety and Smart Infusion Systems.” Journal of Infusion Nursing. 2005;28(5):321–8. 9. Institute of Medicine. “Preventing Medication Errors.” Quality Chasm Series, Washington D.C., July 2006. 10. Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, Shea BF, Hallisey R, et al. “Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group.” JAMA. 1995;274(1):29-34.

© 2011 CareFusion Corporation or one of its subsidiaries. All rights reserved. Guardrails is a registered trademark of CareFusion Inc or one of its subsidiaries. AL105/Oct11/v1

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