New Technology Could Reduce Hospital Drug Errors - page 2

by nursebedlam

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New Technology Could Reduce Hospital Drug Errors Issue Of Patient Privacy Still A Question POSTED: 9:02 pm EDT June 24, 2004 UPDATED: 9:17 pm EDT June 24, 2004 MADISON, Wis. -- The nonprofit Institute of Medicine said... Read More


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    I nursed in AB all around the province and also took my training(AHE, GMCC) there.

    I know that Calgary Health Region has gone with Eclipsys SCM. But, never hear what the other Regions are doing: Edmonton and David Thompson in particular. One thing I notice in this business is that some places will tell you they have something and its just not what you had invisioned. I went to a session a few years ago in TO and noone it seemed had CPOE. Great and wonderful web pages.

    Is there any system in AB that actually has CPOE ? I have also heard that U of A is way behind.
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    Those interviewed did not blame the nurse so much as the system.
    As it should be. Why should medication errors happen because staff is on break and the nurse is rushed?
    (Is that is the case)
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    Quote from oneLoneNurse
    Is there any system in AB that actually has CPOE ? I have also heard that U of A is way behind.
    As far as I know, there is not. I doubt that Capital Health is using it anywhere. UAH definitely doesn't. There are many things we don't have, in fact. Like a pharmacist on site between 2300 and 0700. Ridiculous. Nurses in the ICUs themselves are preparing about 90% of all the meds they give, right at the bedside. There's a huge, region-wide needlestick reporting and prevention program but we are all still using needles. There are Interlink supplies in all the bedside carts, but few people other than me ever use them; most prefer to simply uncap a stopcock. Could be one reason for all our CVC-related blood stream infections, too. Our monitors are slowly dying but we still keep on using them because we have no replacements. We never have enough sterile instruments for the patients we have, much less any admission we may get. The list goes on and on.

    King Ralph announced his plans for reforming health care yesterday. I just got home from work and haven't read the paper yet. I suspect I'm not going to like anything I see there. We can't have an on site pharmacist on nights, but we can go to another province to pick up a patient on ECMO and bring him back here for ongoing ECMO and maybe a heart transplant! Priorities, right?
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    Depending on the size of the hospital your working at, I'm not totally surprised by the lack of pharmacy personal during the night shift. But if you are working at UofA or Foothills I'm floored !

    When I was a floor nurse I used the interlink system. I think I was in High Level,AB or San Angelo,TX the first time I saw the system. It was surprising to me that a smaller system had it and I hadn't seen it at the UofA.

    I listen to CBC Radio One. Seems like the whole health care system is a mess. I lived in Calgary during the King's inauguration into city government. I've been surprised by his behavior subsequently. Really surprised at his AADAC behavior a couple of years ago.

    Most hospitals seem to implement registration systems first then roll out clinical applications later. I would think that each region in AB would have to have at least that(??). I have found it interesting that Kathryn Hannah(UofC) co-authored "Using computers in nursing" in 1984.

    As an aside always great to see a posting from someone back home. Where is this trail ?
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    onelonenurse, you would be stunned at how backwards the u is. that's where i work... in the picu. no cpoe, no unit-dose meds, no pharmacist in the building on nights (and we're a quaternary care centre?!!!), no needleless system, monitors that fail all the time and aren't compatible with the monitors anywhere else in the whole hospital, pumps that aren't at all user-friendly, no support from administration... despite all that we have among the lowest morbidity and mortality for cv surgery in north america. i believe we're in the top three for outcomes, which really is due to the excellent nursing care the patients receive after their surgeries. sure, ivan rebeyka and david ross are top-notch surgeons, but their patients come back to us sick! neither of them is ever willing to let a patient "go" so we pull out all the stops, all the time. they would be why our transport team went out-of-province to pick up a kid who was put on ecmo at the other end, requiring the charter of a cargo plane to get them there, the fire department at the other end to get the equipment to the hospital so they could switch over and then get back to the airport, fifteen dozen long-distance phone calls to try and work the kinks out of the arrangements, and so on. we sent one of our intensivists, a transport nurse, and a transport rt; they left here at just after 8 am and were still not back at midnight. who knows at this point if the kid even survived the trip. things like that just make me insane . who will ever know how many tens of thousands of dollars that whole venture cost us... and the kid isn't even from the province he was picked up from.

    ralphie has gone off the deep end in his quest for power. he is viewed as the reason the liberals were re-elected because he couldn't keep his mouth shut about his plans to defy the canada health act during the run-up to the election. scared all those easily-swayed non-thinkers in ontario into voting liberal. one of the conservatives who was elected said something about ralph not being in touch with reality for along time. no kidding. p3s, private hospitals, user fees, raising health care premiums, where will it end? with the fall election i hope.

    i live in st. albert, just minutes north of edmonton, and one of our most amazing drawing cards is our red willow trail. it runs through the whole city; no home is more than 400 m from the trail, of which by far the nicest part is that which runs for about 8 km on either side of the sturgeon river. there are lots of wild roses growing on either side of the trail and wildflowers everywhere. at one end is the big lake bird sanctuary where the viewing platform is a great place to watch water birds. i regularly see a variety of different sparrow and duck species, coots, geese, red winged blackbirds, the ubiquitous magpies and this one solitary great blue heron. he stands like a statue in the shallow water and watches the water. my little dog loves to walk with me and knows that when i stop to watch the birds she has to lie in the grass and wait quietly. it's my mental health rx! :hatparty:

    sorry for the way-off-topic post...
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    Quote from oneLoneNurse
    don't think the fact that the administration is attempting to squeeze nursing help to the last drop from nurses is the Medical Informatics Department fault.
    Well I think it IS when they introduce a buggy system to our ICU then when we ask for help in implementing it they say "We don't know, it might not work for ICU with all the stats and nows, we've never done this in ICU before."

    We have to enter the stats/now orders into Meditech, THEN manually into the computer EMAR pharmacy system an override (no time to wait for pharmacy to do this for stats in ICU) , THEN get it out of the SureMED as a stat, THEN enter it again as given with the scanner at the bedside. Unbelievably time consuming. I won't work with this sytem again in ICU personally. IMO the nurse is essentially functioning as a pharmacist. :angryfire
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    Quote(Sorry, don't know yet how to get the thread to do this):

    "Well I think it IS when they introduce a buggy system to our ICU then when we ask for help in implementing it they say "We don't know, it might not work for ICU with all the stats and nows, we've never done this in ICU before."

    We have to enter the stats/now orders into Meditech, THEN manually into the computer EMAR pharmacy system an override (no time to wait for pharmacy to do this for stats in ICU) , THEN get it out of the SureMED as a stat, THEN enter it again as given with the scanner at the bedside. Unbelievably time consuming. I won't work with this sytem again in ICU personally. IMO the nurse is essentially functioning as a pharmacist. "

    Yech.

    There needs to be interfaces(HL7) built between the pharmacy system and the front end( Meditech ). In some instances venders are bringing slick salesmen in with $1,000.00 suits to sell the pharmacists a package with all the bells and whistles, BUT which when implemented can't do what they are supposed to mainly because they can't talk to the other systems. Its a crime. Hospitals need to spend the money for feasibility studies rather than rely on venders prior to buying any application.

    Stats/now orders do you chart them in Meditech ? There seems to be a problem with them being ordered but not charted. Since most are given before being charted we have a schedule: "WAS GIVEN AT".
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    [quote=janfrn]onelonenurse, you would be stunned at how backwards the u is. that's where i work... in the picu. no cpoe, no unit-dose meds, no pharmacist in the building on nights (and we're a quaternary care centre?!!!), no needleless system, monitors that fail all the time and aren't compatible with the monitors anywhere else in the whole hospital, pumps that aren't at all user-friendly, no support from administration... despite all that we have among the lowest morbidity and mortality for cv surgery in north america. i believe we're in the top three for outcomes, which really is due to the excellent nursing care the patients receive after their surgeries. sure, ivan rebeyka and david ross are top-notch surgeons, but their patients come back to us sick! neither of them is ever willing to let a patient "go" so we pull out all the stops, all the time. they would be why our transport team went out-of-province to pick up a kid who was put on ecmo at the other end, requiring the charter of a cargo plane to get them there, the fire department at the other end to get the equipment to the hospital so they could switch over and then get back to the airport, fifteen dozen long-distance phone calls to try and work the kinks out of the arrangements, and so on. we sent one of our intensivists, a transport nurse, and a transport rt; they left here at just after 8 am and were still not back at midnight. who knows at this point if the kid even survived the trip. things like that just make me insane . who will ever know how many tens of thousands of dollars that whole venture cost us... and the kid isn't even from the province he was picked up from.

    i am very surprised. that is the nicest hospital. the library is simply out of this world ! they must have a registration system correct ? that would be the first step of getting a system up. in the states we are concerned with charging for every clinical item, probably not as important in canada since the provincial plan( ahip ) pays for everything.

    i remember airlifting someone from high level to uofa and riding in an ambulance from vegreville( they needed a license ) so am familiar with the feeder system. it would be good to have at least a provincial electronic system where you could at least just transfer in the system so the necessary registration work could be found if lost in transit.

    the trail sounds nice.
    Last edit by oneLoneNurse on Jul 6, '04


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