Foreword: safer systems for IV therapy: what role does drug error reduction software play?
rug error reduction software (DERS) is designed to highlight and help remove programming errors that can lead to non-therapeutic
treatments and potentially fatal doses. With clear evidence of its benefi ts, why is it that in health care we continue to use high-risk devices like infusion pumps without such safety systems, or with the safety software switched off? Can we really just rely on our training, knowledge and memory?
Although safety software cannot cover the large number of infusions delivered via gravity and manual bolus injection, many millions of infusions are delivered via medical infusion devices (volumetric pump and syringe pump). Complex dose calculations and high-risk medications will continue to be delivered in this way.
Recent reports suggest that DERS can save lives, reduce risk and ensure safe and effective intravenous infusions. Its critics suggest complex programming issues, lack of organisation-wide standards, and user non-compliance and apathy are holding back progress. Effective IT infrastructures, ongoing support from manufacturers and a dedicated team are the minimal requirements for an effective safety system. Regular audits and reviews, software upgrades and compliance checks are crucial too. Anything less and the safety system will fail.
This series of articles highlights important issues and asks you to consider whether your organisation is offering patients the safest infusions possible. Authors share their experiences and offer insights into implementing such systems, giving both European and US perspectives.
A common theme throughout is the prescription limits, high and low, set by the software. Should these be set in stone, or fl exible? Will errors be picked up by the
software? Can human trips and slips be highlighted and removed by the application or software?
Fully automated safety systems seem to be the way forward. These could prescribe, dispense, label, program (wirelessly) and barcode the right medication at the right dose at the right time—for the health professional to administer to the right patient.
What is clear from all the articles here is that a multidisciplinary team approach is essential and that implemention of DERS is just one part of a wider system. Sole reliance on policies, training and human judgement is a fl awed plan. Technology, tailored safety programs and medical devices point the way to the future.
DERS is only one component of intravenous safety. The need for better understanding of human interaction, the extra time required to program pumps and a cultural shift towards dose-programming may mean that a truly integrated system is still some way off. Nevertheless, users and purchasers need to be able to drive the market on to produce better, safer, simpler software to reduce risks even further.
After all, we or someone close to us is likely to receive some form of infusion or intravenous therapy in our lifetime. When that happens, we would want that person using the device, the organisation that purchased it and the manufacturer that developed the software, to have done their best to ensure that the therapy being administered is safe, timely and effective.
Paul T. Lee Medical Devices Training Manager, ABM University Health Board, Morriston Hospital
BJN July 2013 CareFusion Supplement 3
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