Medication errors reduced to a minimum thanks to HiX's Medication Preparation module
Administering medication is an extremely delicate and error-prone process: the right amount must be administered to the right patient at the right time. This especially applies to parenteral medication. Dijklander Hospital now uses HiX in this process. The EHR verifies whether all required steps of preparation and administration are taken correctly.
Pharmacist Inge Arfman has dedicated much of her time to this project during the past year. 'There was more to it than we initially expected: we not only had to formulate all preparation protocols, but we also had to set up the complete infrastructure regarding the implementation. The first departments have now started working with the new module, and we hope others will quickly follow.'
Manual labour
Arfman and assistants from the clinical pharmacology departments have formulated over 700 protocols, and the tally continues to rise. For every medication, a step-by-step plan must be formulated for each form (bolus, short-term infusion, syringe driver, etc.) and route of administration (intravenous, subcutaneous, etc.). This will act as the base to assist the nurse with the preparation. Arfman: 'Previously, the nurse would need to manually gather the required materials and tools based on the physician's prescription and then use the instructions from the Dutch 'Handbook for Parenteral Medication' to calculate the required volumes. Then, in order to prevent human errors, the preparing nurse would ask a colleague to verify the preparation, interrupting this colleague from their own tasks. It's a system vulnerable to errors.'
Barcode
'With HiX's new Medication Preparation module, the nurse can use a scanner to scan the barcode on the drug vial or ampoule to verify its contents and to prompt step-by-step instructions for the preparation. Only when the entire preparation process is completed, a label containing a barcode is printed and can be placed onto the infusion bag or the syringe containing the medication. At the patient's bedside, the nurse first scans the patient's wristband and then the barcode on the product containing the medication. The new medication preparation system is fully integrated into the EHR, meaning that, upon scanning, the system will immediately verify whether the right patient is administered the right medication at the right time. If even the slightest thing is off, the nurse is immediately notified', says Arfman. Integration with the EHR also means that all actions in the preparation and administration process are automatically registered in HiX, protecting the process from any human errors. Additionally, it makes routine double-checks by colleagues redundant in most cases, meaning that the nurses will no longer have to disturb colleagues busy with their own work.
Increased safety
Bas de Lange is a nurse in the orthopaedics/geriatrics department at Dijklander Hospital in Hoorn, the Netherlands, and has recently started using the new HiX module. 'The new Medication Preparation module in HiX is a perfect example of how new technologies are able to support nurses with an increasingly complex request for care. This new way of working not only ensures increased patient safety, but will also save a lot of time in the long run. It truly helps to enhance the quality of care we're able to provide at Dijklander Hospital.'
'We are aware that this system, at least at the start, will not be much faster', hospital pharmacist Willem Jan Keijer explains. 'Working with barcodes will take some getting used to, but once the staff learn to use and become familiar with the system and the HiX module, the payout in terms of time savings and increased patient safety will make it well worth it. And in the end, that's what is most important!'