scholarly journals INTEGRATION OF THE TRANS-OPERATIVE INFORMATION WITH THE PATIENT'S ELECTRONIC RECORD

2019 ◽  
Vol 2 (1) ◽  
pp. 23-27
Author(s):  
MARCELO ANTUNES MARCIANO ◽  
Eliezer Knob Souza

This article presents an integration project between the anesthetic station used in the step of trans-operative (life signals multiparameter monitor, anesthesia device and controlled target infusion pump) and the system of hospital information. The main goal of this project is to capture in an automatic way the vital signals from the medical equipment and the records trans-operatives and provide an anesthesia record to be storage in the patient’s electronic medical record (PEMR). The integration mode is through a gateway that execute the conversion of the machine - specific language into data/information of the HL7 standard. This interaction will allow to integrate data and information from multiparametric monitors, anesthesia devices, Controlled target Infusion pumps and the intra-operative anesthesiologist inputs.

2020 ◽  
Vol 77 (15) ◽  
pp. 1231-1236
Author(s):  
Roy Joseph ◽  
Sang Weon Lee ◽  
Scott V Anderson ◽  
Matthew J Morrisette

Abstract Purpose To describe the benefits of smart infusion pump interoperability with an electronic medical record (EMR) system in an adult intensive care unit (ICU) setting. Summary In order to assess the impact of smart infusion pump and EMR interoperability, we observed whether there were changes in the frequency of electronic medication administration record (eMAR) documentation of dose titrations in epinephrine and norepinephrine infusions in the ICU setting. As a secondary endpoint, we examined whether smart pump/EMR interoperability had any impact on the rate of alerts triggered by the dose-error reduction software. Pharmacist satisfaction was measured to determine the impact of smart pump/EMR interoperability on pharmacist workflow. In the preimplementation phase, there were a total of 2,503 administrations of epinephrine and norepinephrine; 13,299 rate changes were documented, for an average of 5.31 documented rate changes per administration. With smart pump interoperability, a total of 13,024 rate changes were documented in association with 1,401 administrations, for an average of 9.29 documented rate changes per administration (a 74.9% increase). A total of 1,526 dose alerts were triggered in association with 76,145 infusions in the preimplementation phase; there were 820 dose alerts associated with 48,758 autoprogammed infusions in the postimplementation phase (absolute difference, –0.32%). ICU pharmacists largely agreed (75% of survey respondents) that the technology provided incremental value in providing patient care. Conclusion Interoperability between the smart pump and EMR systems proved beneficial in the administration and monitoring of continuous infusions in the ICU setting. Additionally, ICU pharmacists may be positively impacted by improved clinical data accuracy and operational efficiency.


2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Lars-Ola Bligård ◽  
Anna-Lisa Osvalder

To avoid use errors when handling medical equipment, it is important to develop products with a high degree of usability. This can be achieved by performing usability evaluations in the product development process to detect and mitigate potential usability problems. A commonly used method is cognitive walkthrough (CW), but this method shows three weaknesses: poor high-level perspective, insufficient categorisation of detected usability problems, and difficulties in overviewing the analytical results. This paper presents a further development of CW with the aim of overcoming its weaknesses. The new method is called enhanced cognitive walkthrough (ECW). ECW is a proactive analytical method for analysis of potential usability problems. The ECW method has been employed to evaluate user interface designs of medical equipment such as home-care ventilators, infusion pumps, dialysis machines, and insulin pumps. The method has proved capable of identifying several potential use problems in designs.


2019 ◽  
Vol 7 ◽  
pp. 205031211882262
Author(s):  
Alexander F van der Sluijs ◽  
Eline R van Slobbe-Bijlsma ◽  
Astrid Goossens ◽  
Alexander PJ Vlaar ◽  
Dave A Dongelmans

Background: Medication errors occur frequently and may potentially harm patients. Administering medication with infusion pumps carries specific risks, which lead to incidents that affect patient safety. Objective: Since previous attempts to reduce medication errors with infusion pumps failed in our intensive care unit, we chose the Lean approach to accomplish a 50% reduction of administration errors in 6 months. Besides improving quality of care and patient safety, we wanted to determine the effectiveness of Lean in healthcare. Methods: We conducted a before-and-after observational study. After baseline measurement, a value stream map (a detailed process description, used in Lean) was made to identify important underlying causes of medication errors. These causes were discussed with intensive care unit staff during frequent stand-up sessions, resulting in small improvement cycles and bottom-up defined improvement measures. Pre-intervention and post-intervention measurements were performed to determine the impact of the improvement measures. Infusion pump syringes and related administration errors were measured during unannounced sequential audits. Results: Including the baseline measurement, 1748 syringes were examined. The percentage of errors concerning the administration of medication by infusion pumps decreased from 17.7% (95% confidence interval, 13.7–22.4; 55 errors in 310 syringes) to 2.3% (95% confidence interval, 1–4.6; 7 errors in 307 syringes) in 18 months (p < 0.0001). Conclusion and Relevance: The Lean approach proved to be helpful in reducing errors in the administration of medication with infusion pumps in a high complex intensive care environment.


Author(s):  
Zehra Gok Metin

The study aimed to produce a new pump with different and improved features and included three phases. In phase one, we collected the views of 40 nurses on pumps available in the market. In phase two, a pump was designed and a prototype was produced. In phase three, 10 nurses used and evaluated the prototype. The prototype combined three intravenous infusion pumps and one enteral pump in a single machine. Nurses assessed the prototype in a practice laboratory. All nurses found prototype very adequate with respect to carrying and installing. 90% of nurses found the prototype very adequate and practical in general. Moreover, the majority (80%) stated that the prototype produced less noise than the available pumps in the market.  Keywords: Nurse; design; infusion pump; enteral nutrition; patient safety.   


Author(s):  
Ellen S.M. Hilbers ◽  
Claudette G.J.C.A de Vries ◽  
Robert E. Geertsma

Objectives: This study aimed to investigate the technical documentation of manufacturers on issues of safe use of their device in a home setting.Methods: Three categories of equipment were selected: infusion pumps, ventilators, and dialysis systems. Risk analyses, instructions for use, labels, and post market surveillance procedures were requested from manufacturers. Additionally, they were asked to fill out a questionnaire on collection of field experience, on incidents, and training activities.Results: Specific risks of device operation by lay users in a home setting were incompletely addressed in the risk analyses. A substantial number of user manuals were designed for professionals, rather than for patients or lay carers. Risk analyses and user information often showed incomplete coherence. Post market surveillance was mainly based on passive collection of field experiences.Conclusions: Manufacturers of infusion pumps, ventilators, and dialysis systems pay insufficient attention to the specific risks of use by lay persons in home settings. It is expected that this conclusion is also applicable for other medical equipment for treatment at home. Manufacturers of medical equipment for home use should pay more attention to use errors, lay use and home-specific risks in design, risk analysis, and user information. Field experiences should be collected more actively. Coherence between risk analysis and user information should be improved. Notified bodies should address these aspects in their assessment. User manuals issued by institutions supervising a specific home therapy should be drawn up in consultation with the manufacturer.


Author(s):  
Denny Yu ◽  
Kang-Yu Hsu ◽  
Joon Hong Kim ◽  
Poching DeLaurentis

Infusion pumps are medical devices that deliver medication, fluids, and nutrients in a precise and controlled manner that is critical to patient care. This study proposes using infusion pump informatics on all-infusion datasets to understand current impact of alerts and alarms on patient care and health practitioner workflow. All-infusion datasets contain infusion data for both normal and abnormal use, i.e., error states. Ten months of continuous data was collected from one health institution. Analysis of variance with log-transformation and logistic regressions were used to analysis contributing factors for alerts and alarms states. A total 64,511 minutes of alarm activation were observed, where alarms were active prior to being resolved. Mean resolution times for 83% of alarms were one minute or less; however, 3% or alarms required >4 minutes before getting resolved. Risk factors for infusions with alerts included nursing shift variables. Specifically, odds for alerts were 1.3 times higher for infusions that span across shifts than infusions in the day shift.


2013 ◽  
Vol 82 (8) ◽  
pp. 702-707 ◽  
Author(s):  
Junghwa Jang ◽  
Seung Hum Yu ◽  
Chun-Bae Kim ◽  
Youngkyu Moon ◽  
Sukil Kim

Author(s):  
S-W Choi ◽  
S-M Kang ◽  
H-Y Kim ◽  
K-W Nam

Passive-type drug infusion pumps have several advantages over active-type pumps including a simple drug chamber structure and relatively high operational stability. However, conventional passive-type infusion pumps also have several limitations compared to active ejection pumps, such as a fixed flowrate and monotonic flow pattern. To enhance the clinical feasibility of using passive-type drug infusion pumps, flow readjustment and flow regulation abilities are needed. This paper proposes a new portable elastic drug infusion pump that integrates the advantages of active and passive infusion pumps to improve clinical feasibility. The proposed infusion pump incorporates a passively driven drug chamber and an actively adjusted flow controller, which can adjust and regulate various target flowrates and adjust the flow pattern in accordance with the patient’s time-varying physiological status. The proposed infusion pump uses the contraction force of an expanded elastic membrane to extract the drug from the drug chamber for delivery into the patient’s body through an outlet catheter. It also utilizes a flow sensor, a flow resistor, and a motor-driven flow restrictor that can monitor the real-time flowrate through the outlet catheter and automatically regulate the actual flowrate around the target value. Experiments on the proposed system resulted in actual injection rates of 0.49 ± 0.03 (mean ± standard deviation), 0.98 ± 0.03, 1.49 ± 0.04, and 1.99 ± 0.03 ml/h when the target injection rate was set to 0.5, 1.0, 1.5, and 2.0 ml/h, respectively. During the entire period of operation from the fully filled state to the totally empty state, an inner-chamber pressure of >100 mmHg was maintained, which shows that the proposed infusion pump can stably maintain its target flowrate as the amount of drug remaining to be injected decreases. It appears that the proposed drug infusion pump can be applied to a wide variety of patient treatments that require short-term, accurate, and stable drug delivery.


Author(s):  
Kaifeng Liu ◽  
Foon-yee Chan ◽  
Calvin Ka-lun Or ◽  
David Tin-fung Sun ◽  
Mavis Wai-see Lai ◽  
...  

In this study, we report on nurses’ perceptions of the ease of use of four infusion pumps, the mental effort exerted when using the pumps, and the likelihood of programming errors. The key features and operations of the pumps are presented in Table 1. Perceptions were measured after each pump was used in an end-user test. This involved performance of simulated infusion tasks developed by a group of healthcare professionals including nurses and physicians, based on the practical tasks nurses perform with infusion pumps. The tasks included priming and loading the infusion sets, the startup and shut down of the infusion pump, setting basic infusion, and the use of a drug library. The test was conducted in a simulated patient room with a bed, drip stands, and a trolley loaded with solution bottles and administration sets. Sixty registered nurses from five clinical units of three large public hospitals were studied. Perceived ease of use was assessed by seven items adapted from Ginsberg (2005), of which two items (I1 and I2) concerning sets priming and loading (e.g., “Easy to prime and load”), three items (I3, I4, and I5) concerning basic infusion setting (e.g., “Easy to program a basic infusion”), one item (I6) concerning turning on/off the pump (i.e., “Easy to turn on and turn off the pump”), and one item (I7) concerning the usage of drug library (i.e., “Easy to program a drug infusion from drug library”). The items were rated on a 7-point scale ranging from 1 (very strongly disagree) to 7 (very strongly agree). Perceived mental effort was measured by two items (I8 and I9; e.g., “How much mental effort is required when setting up and programming the infusion pump?”), and perceived likelihood of programming errors was examined by one item (I10; i.e., “How likely is it that you would make infusion pump programming errors due to the complex design of the pump?”). These were rated on a 7-point scale ranging from 0 (not at all) to 6 (a great deal). Using a one-way repeated measures analysis of variance, we compared the differences in each of the three perception variables among the four pumps. The correlations among the variables were evaluated using Pearson correlation coefficients. Table 2 shows the means and standard deviations of the variables and the pairwise comparison results. Our results indicated that Pump 3 yielded the highest perceived ease of use, followed by Pump 2, Pump 4, and Pump 1. Pump 3 also achieved a lower perceived mental effort and a lower likelihood of programming errors than the other pumps. Perceived ease of use was negatively correlated with perceived mental effort (rpump1 = -0.53, rpump2 = -0.39, rpump3 = -0.54, rpump4 = -0.30, all p values < 0.05) and perceived likelihood of programming errors (rpump1 = -0.54, rpump2 = -0.34, rpump3 = -0.60, rpump4 = -0.49, all p values < 0.01). It appears that an infusion pump that provides informative feedback on its status and allows simple programming operations is more likely to be perceived as easy to use. Improving the ease of use of the pumps may reduce the mental effort required, and users may perceive they are less likely to make programming errors during use. Critical to the design of effective infusion pumps is the consideration of human factors, which can improve ease of use and simplify the design.


Author(s):  
Nisa'ul Sholihah ◽  
Abd Kholiq ◽  
Sumber Sumber

Infuse pump is a medical equipment which is design to control and regulate the administration of intravenous fluids in the treatment.. This module uses the L298N motor driver as a stepper motor controller. The choice of the infuse pump setting is the volume setting from 100 ml to 500 ml and the speed setting of 30 ml / hour, 60 ml / hour, and 90 ml / hour. The author uses the Atmega 328 microcontroller as a droplet controller per minute, volume and speed. Occlusion in this device is in the detector of the droplets that are alerted in the presence of a sound buzzer. This tool is also equipped with monitoring volume, tpm and speed on a wireless-based PC using HC-11 as a transmission from module to PC. This tool is equipped with oclusion. The flow rate data processing in IDA from infusion got the highest error result at the setting of 30 ml / hour which was equal to 5.97%. the highest error for the calculation of droplets in the module is the setting of 30 ml / hour which is equal to 32% and manually at setting 60 which is 23%.


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