Achieving compliance with The Joint Commission’s Sentinel Event Alert on optimizing smart infusion pump safety with DERS.
Part Two of Four: Recommendations 3 and 4
Ivyruth Andreica PharmD, BSN, FISMP, Clinical and Medication Safety Pharmacist, Ivenix, Inc.
The Joint Commission recently issued a Sentinel Event Alert regarding optimizing smart infusion pump safety with dose error reduction software (DERS).1 Currently, DERS is the standard of care for ensuring healthcare organizations safely administer IV infusions1. Best practices state that healthcare organizations should have Dose Error Reduction Software (DERS) compliance goals of at least 95% or better.2 However, many healthcare organizations implementing infusion technology do not realize all of the benefits of smart infusion pumps.
In this four-part series, we will examine each of the recommendations identified in “Sentinel Event Alert 63: Optimizing Smart Infusion Pump Safety with DERS” made by The Joint Commission. We will also share how the Ivenix Infusion System supports hospitals in improving patient safety by addressing the challenges presented by these recommendations.
Related: Read Part One: Recommendations 1 and 2
Joint Commission Recommendation #3:
Train and assess competency of all clinical staff, including nurses and other clinicians who travel to various care settings1.
Ivenix has a shared company vision of eliminating infusion-related patient harm. This vision includes a commitment to ensure clinicians fully understand how to use the infusion system, are well trained in a short time, and have a library of guidance resources at the pump display when programming an infusion order.
Figure 1: Ivenix Resource Library
Guidance and training resources are viewed as fundamental clinician needs. Ivenix meets this need with e-training modules compatible with hospital training software platforms and a unique instructional resource library built into the menus of the pump display. As shown in Figure 1 above, this Resource Library is accessible on the infusion pump to help clinicians with hospital policy, best practices documents, or supporting references.
Simplifying infusion pump programming workflows translates to an intuitive and simplified training experience. The user interface is designed from the ground up with a focus on task efficiency and safety. The infusion pump setup process identifies the clinician. It automatically selects the care profile of their assigned unit or department to simplify input options and limit the possibility of an incorrect care profile selection. The workflow simplicity reduces training time and IV setup steps.
Joint Commission Recommendation #4:
Make the optimal use of DERS expected practice1.
The Ivenix Infusion System defaults directly into DERS programming. Clinicians do not have to “opt in” to use the drug library. In addition, clinicians can readily see a graphical representation of the DERS limits with an obvious indication of when the infusion is operating outside DERS. This “Not in Library” indication is displayed on the pump when a clinician has chosen programming without DERS as shown in Figure 2 below.
Figure 2: Infusion programmed “Not in Library” indicator (shown circled in red)
The Ivenix Infusion System also aligns drug library editor views with a unique visual display on the infusion pump. This “Visual DERS” is displayed as a red-yellow-green “rainbow” for both the drug library contributors and the clinician at the bedside to visualize limits. Figure 3 below shows the graphic presented to the drug library contributor within the editor software.
Figure 3: Visual DERS in drug library editor software
Figure 4 below shows examples of the three visual alerts displayed on the pump screen corresponding to infusion parameters programmed within range, out of the soft limit range, and out of the hard limit range.
Figure 4: Visual DERS displayed by Ivenix large volume pump
The Ivenix Infusion System DERS updates are transferred wirelessly and take effect without interrupting clinical use. Real-time drug library build and revision collaboration software can reduce or replace in-person, and often challenging to coordinate, infusion committee meetings. This software-based collaboration tool supports the rapid creation and revision of the drug library and pump settings. By simplifying deployment and visualizing DERS within the infusion pump programming workflows, the Ivenix Infusion System encourages optimal use of DERS to achieve better compliance.
Read about how in 2019, the Ivenix Infusion System won the Human Factors and Ergonomics Society (HFES) 18th Annual Stanley Caplan User-Centered Product Design Award
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1. The Joint Commission. Optimizing Smart Infusion Pump Safety with DERS. Sentinel Event Alert. 4-14; 2021; Issue 63
2. Institute for Safe Medication Practices. Guidelines for optimizing safe implementation and use of smart infusion pumps. 2020