Abstract
ABSTRACT Background: Smart pump integration with Electronic Medical Record (EMR) systems offers an opportunity to introduce a closed-loop medication management system in hospital settings. Closed-loop medication management systems minimise human errors, improve nursing workflow and efficiency, and optimise patient safety. In this descriptive observational study, we will outline some of the key steps required to successfully integrate a smart pump dataset with EMR computerised provider/physician order entry (CPOE) systems. Methodology: The triple C model of consultation, collaboration and consolidation was used for the development and implementation of a smart infusion pump and EMR integration at a 160-bed specialist Australian hospital. This systemised approach allowed a methodical implementation process and ensured sustainability of the intervention. Key stakeholders were identified and engaged to establish a working group to align medication orders in the EMR and the smart pump library to ensure readiness of pump-EMR integration phase. Validation testing was conducted for each EMR infusion order to check successful auto-programming to a corresponding medication on the smart pump. The steps discussed are applicable to all hospital settings with EMR systems and smart pumps. Results: The smart pump dataset contained a total of 217 unique medications and fluids that were tested for interoperability. A total of 87% (188/217) passed full record testing. The remaining 13 % (29/217) were excluded from interoperability. The 13% of medication and fluids that were excluded was due to the medication being prescribed on paper (i.e. medicines with desensitisation regimen), the medication unable to be prescribed as a medicine in the EMR (i.e. blood products), the smart pump limitations to build safety limits around only one medicine (i.e. multi-additive infusions) or excluded due to specialist hospital formulary. Conclusion: This study using a systemised approach, that described and identified key stages and phases required for integration of smart pump infusions with an EMR system, to create a closed-loop medication management system in an Australian hospital setting. Highlights
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