Lauren Lobaugh, MD, MAS, FAAP, understands what it is to make a medication error. During her fellowship at the Children's Hospital of Philadelphia, she mentally miscalculated and gave her patient double the indicated dose of Toradol, a non-steroidal anti-inflammatory (NSAID).
The days that followed were a tense cadence of observation and intervention. Fortunately, the child was unharmed, but it was a wake-up call.
Dr. Lobaugh is now an Assistant Professor at Baylor College of Medicine in the Department of Anesthesiology, Perioperative, and Pain Medicine and a pediatric anesthesiologist at Texas Children's Hospital in Houston, Texas. In addition to her clinical work, she serves as an expert in healthcare quality and advocates for using technology in OR safety.
The Food and Drug Administration receives more than 100,000 reports of medication errors annually, but Dr. Lauren Lobaugh suspects that the actual figure is much higher. Yet despite these statistics, the adoption of proven medication safety technology in the perioperative setting is surprisingly low. While automated dispensing cabinets are used in nursing units in 95 percent of U.S. hospitals, similar technology is used in the OR by only a little more than half of hospitals.
Data from ISMP suggests medication-related events occur in all phases of the perioperative process:
- One observed medication error in half of all surgical procedures
- One self-reported event in every 1,285 procedures
- One event in every 20 medication administrations; more than one-third led to patient harm
Among the recommendations in the recently released ISMP Guidelines for Safe Medication Use in Perioperative and Procedural Settings is guidance for prioritizing the use of automation in medication management and for the implementation of barcodes or other machine-readable codes.
"We would love to see ways in which barcode technology…can be used to support the anesthesia providers and the inter-op providers as they select and administer medications," said Susan Papparella, MSN, RN, and vice president of services at ISMP.
Omnicell XT Anesthesia Workstation supports these recommendations through an integrated printer that prints Joint Commission-compliant, color-coded labels with barcodes for syringes, enabling scanning directly into the EHR. Additionally, Omnicell has the only anesthesia workflow solution that offers Closed Loop Dose Accountability, which helps protect patient safety by managing all processes, including intake, administration, and disposal of medications.
We continue to innovate by working with organizations like ISMP to find technology solutions supporting the highest levels of care.
Learn more about Omnicell's XT Anesthesia Workstation.
Disclaimer
The views and opinions expressed in this blog are those of the authors. They do not necessarily reflect the official policy or position of any other agency, organization, employer, or company. Assumptions made in the analysis do not reflect the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.