Medication Matters. . . in Patient Safety

Smart Pump Integration with BCMA and CPOE Helps Keep Patients Safe

By Jean Phillips, editor

When it comes to preventing medical errors, medication matters—a lot. Industry watchdog The Leapfrog Group recently added medication errors to its bi-annual hospital grading system because they are a significant cause of patient safety events. IV medication delivery issues, in particular, frequently appear on ECRI’s annual list of the Top 10 Health Technology Hazards. For 2019, infusion confusion—mixing up dose rate and flow rate when setting up IV infusions–made the annual list, which was released this October. In fact, statistics show that one in 10 IV drug delivery errors is preventable, just like confusion over dose and flow.

Perhaps surprisingly, two of the three technology solutions that can make an important difference in preventing IV medication errors are already in place in many hospitals.  These are bar code assisted medication administration (BCMA) – think scanners and plastic arm wristlets , as well as  computerized physician order entry (CPOE), systems that enable physicians to enter patient treatment instructions electronically to avoid confusion, This year, a survey of more than 350 pharmacy directors by Pharmacy Purchasing and Products found that adoption of both technologies among hospitals is high, and research has shown that both have a major impact when interfaced with pumps.

However, the high cost of that integration is a significant barrier to implementation. Therefore, hospitals continue to rely on dose error reduction systems (DERS) as a key line of defense against IV errors. But the reality is that clinicians continue to override of these systems with some frequency. Moreover, not all hospitals have implemented DERS. As a result, manual pump programming is still common—and errors result.

The Institute for safe Medication Practices recently met to update its 2009 smart pump safety guidelines. Participants were extremely vocal about their support for the integration of BCMA with pumps.

As pharmacists make plans for the American Society of Health System Pharmacists (ASHSP) meeting, medication safety will be on everyone’s minds. The statistics and events cited above have once again put medication safety and IV medication safety in particular, in the spotlight—as well they should.

Pharmacists—the hospital’s medication experts— are highly appropriate to champion BCMA and CPOE integration with IV pumps to ensure the drug delivery they oversee is error-free. Nurses too play an important role because the integration will alter their workflow, and they will have to change and adjust. The technology exists to prevent IV medication errors.  When hospitals fail to put it to work, are they really putting patients first?