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Few registered nurses work full time
for the pharmacy department. How did that come about?
I noticed that some of our nurses were struggling with
the new pharmacy technologies that were being introduced
and I saw that there was no liaison between the pharmacy
department, the nursing department and the technology
vendors. So, I pointed out some of these issues and
they asked me to help out for two weeks. I have now
been in the pharmacy department for a year and a half.
We are using a number of new technologies including
a new IV Mixture Robot-the first of its kind in the
United States. As another example, a large number of
medication errors occurs from manually programming pumps.
The new B. Braun pumps [that we have implemented] are
programmed automatically through the use of bar codes
so the nurse can now just check the pump and accept
or reject the programming-this second step is required
as confirmation that the information on the bar coded
label is the same as the order. These new pumps have
the capability to send a message to the pharmacy department
before a bag runs out so that the pharmacy can refill
the medication without requiring the nurse to handle
this step.
We are also one of about eight hospitals using the
AcuScan Point of Care device, and we are the only children's
hospital that has implemented it in all general care
inpatient units. This system allows us to reduce medication
errors because it is more precise than any human being
could be-and that's critically important in a pediatric
setting where nonstandard doses are commonly required.
First, we don't think of Point of Care as a pharmacy
tool, but rather as a nursing tool. It's a system that
performs a three-way match between the nurse, the patient
and the medication to ensure accuracy. A nurse scans
his or her employee badge and then scans the medication.
The system verifies that the medication is correct for
the right medication, dose, time and route. If everything
is OK to this point, the nurse scans the patient's wristband
as a final check. Soon, we will be testing an extension
of this system that utilizes our handheld [PDAs] with
a desktop view option.
One of the biggest challenges is getting experienced
nurses to trust the system. By contrast, we have some
new grads who have never used anything but the Point
of Care system. Overall, it has been a smooth and enjoyable
transition for me. I leave my pager on 24/7 in case
our nurses need assistance with the devices and, the
fact is, I seldom get beeped.
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