Smart Device IntegrationImproved Documentation Accuracy in Anesthesia

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Documentation Causes 16% of Injectable Medication Errors

1 IMSP high alert medication list, IMS data2 Weigner et al, 1994

The views and opinions expressed are those of BD

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Case Study #1: Unintentional Misdocumentation

Example: Rocuronium Administration Data Inaccuracies

Situation:• Hospital was meticulous in assessing muscle relaxant use.

• Received daily report of all cases with the use of drugs like Rocuronium, as well as monitoring used.  

Challenge:

• Hospital was certain a drug like Rocuronium was given, but nothing was logged in Epic.

• Believed if this was happening with one drug, it was happening with many more.

Desired Solution:

• Ability to see an injected drug was logged in Epic and billed.

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Case Study #2: Unintentional Misdocumentation

Example: Retrospective Charting During Emergencies

Situation:

• Despite implementing an AIMS, difficult to defend anesthesiologists’ actions during adverse events.

• Caused by incomplete retrospective charting that occurs during emergencies.

Challenge:• Inappropriate for clinicians to divert their attention

from the patient to charting while emergency is occurring.

Desired Solution:

• Effective solution to assure the reliable and accurate documentation of intravenous medications for use during emergency situations.

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Case Study #3: Patient Safety Risk Identification

Example: Prophylactic Perioperative Antibiotic Dosing

Situation:• Higher than expected surgical site infections (SSIs)

despite anesthesia records suggesting strong compliance with intraoperative intravenous antibiotics.

Challenge:

• The Infection Control Committee felt this was due to failures to give perioperative antibiotics at the appropriate time.

• In some cases, the Committee felt a different antibiotic would have decreased the likelihood of the SSI.

Desired Solution:

• A more reliable and accurate method of capturing intravenous antibiotic dosing.

• Decision support that recommends the most appropriate antibiotic regimen at the time of pre-incision administration.

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Medication administration data entry is largely a manual and tedious process within the Anesthesia

workflow

• Data inconsistencies between medications administered and documented

• Retrospective documentation during emergencies

• Limited narcotic auditing and decision support solutions

• Complex legacy HIT systems with limited integration capabilities

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Overarching Documentation Challenges

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• A new class of device is being brought to market for automating the electronic capture of IV injectable drug data.

• These devices are similar to infusion pumps:

– They provide integration with hospital IT systems,

– Offer improved clinical workflows and

– Real-time patient safety checks for IV drug delivery.

• At the same time, they are sufficiently different from infusion pumps to warrant an independent device classification.

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The Solution

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A medication management solution for IV bolus injections that may help manage the risk of medication errors and improve documentation accuracy.

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The BD Intelliport™ System

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Captures real-time drug identification and dose measurement data

Captures time given

Wirelessly sends medication administration data directly into the patient’s EMR

BD Intelliport™ System Features:

APSF Recommendations:

“Every anesthetizing location should have a mechanism to:

1. Identify medications before drawing up or administering them (bar code reader) and a mechanism to

2. Provide feedback, decision support, and

3. Documentation (automated information system).”

Identifies source container drug name and concentration via barcode scanning

Automatically identifies drug name and concentration

Audibly announces drug and concentration Performs real-time, patient-specific allergy

checking with audible alerts

Aligned with APSF Recommendations

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• BD Intelliport™ Gateway was architected from the bottom-up to support Integrating the Healthcare Enterprise’s (IHE) PCD-01 Profile

• Utilizes common HL7 messaging structures for inbound and outbound interfaces

• Integration has been, or is in the process of being, developed with the following IT partners:

Designed for Standards-Based Interoperability

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Inbound & Outbound Data Exchange

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Documentation Challenges: BD Intelliport™ System:

Documentation data inaccuracies

Automatic documentation that • reduces manual documentation efforts, • improves documentation accuracy and • eases charge capture by wirelessly sending

information on drug, dose, time, and route of administration directly into the patient’s EMR.

Automated med administration data collection that• can help support assessment of some National

Quality Hospital Measures, such as Surgical Care Improvement Project (SCIP).

Controlled substance reporting that • aids anesthetists and pharmacists with med

reconciliation.  

Retrospective documentation during emergencies

Limited decision support solutions

Improved Documentation Accuracy via Smart Device Integration

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Thank you

13The views and opinions expressed are those of BD