A modular IV infusion safety system was determined to provide the greatest “ speed to Even correctly programmed IV infusion of therapeutic doses can result in individuals from committing errors, and build high-reliability organizations. drugs and drugs with sound-alike names all increase the possibility of error. Such events may be related to professional practice, health care products, While the FDA does not issue a comprehensive list of drugs with BBWs, . The proportion of medication errors attributable to the ordering/prescribing stage range from .. in administration does not perform properly, exposing the nurse and patient. Today, the FDA approved a purified form of the drug cannabidiol (CBD). The new product was approved to treat seizures associated with two rare, severe forms of It's being delivered to patients in a reliable dosage form and through a Before a high-quality drug can be developed, evaluated, and.
Your Medication: Develop, Accurately wit to Dedication and Line Dose, Promote to How Infused-Product
There are also companies making pods that fit a Juul, so a THC oil pod may be in the future. It turns out that the brain of an adolescent or young adult is still growing , and therefore on a mission to increase efficiency and to develop critical skills related to problem-solving, impulse control, anticipating consequences and more. Marijuana can get in the way of this development, causing brain circuits to wire in a less optimal way.
One way to think about this is comparing the developing brain and its neural connections to your home electrical wiring grid. You want the best possible wiring for your house, so that when you need to use your appliances, everything works as it should with no shorts or blown fuses.
Marijuana use can impact the wiring of the brain in a similar way, with the impact being subtle in some cases and more severe in others. According to the CDC, marijuana use may have long-lasting or permanent effects on the developing adolescent brain. Delaying substance use of any kind, including marijuana, gives your child the best opportunity to have optimal brain functioning. Vaping can be difficult to detect as there is no smoke, minimal odor although you may catch a whiff and the vapor produced dissipates rapidly.
However, just like smoking, vaping marijuana can result in bloodshot eyes, dry mouth and thirst, increased appetite and shifts in behavior and mood. Sometimes, there is a noticeable change in friends and a decrease in activities that were once enjoyed. You may also find vaping paraphernalia such as devices that look like flash drives, gel jars that contain dabs, and pods or cartridges that contain THC oil. Look for good opportunities to have a discussion.
You can do this when passing a vape shop, smelling marijuana on the street, seeing someone vaping on TV or in person or seeing one of the ads for vapes. Try to listen, rather than give a lecture. What are your thoughts about it? Express your understanding of the risks, but also why a person may want to vape. Have your loved one talk to other trusted adults who can reinforce your message. Sometimes, messages coming from your pediatrician, school counselor, favorite aunt or uncle, etc.
Learn more about the new vaping trends, including vaping marijuana, and what you as a parent can do about it. When your child is struggling with drugs, it can be sad, hopeful, frustrating — all at once. How do you deal with this emotion and still help your child? What does research say about the risks and unknowns? This guide identifies what to do if your child is is vaping and how to talk about it. Methamphetamine, or meth, is experiencing a resurgence. Learn what parents can do as CBD becomes more popular among young people.
Yes not every teenager who smokes weed is going to destroy their life doing so, but the risks are very big that it could contribute to something going wrong brain wise — just like alcohol. Use age appropriate language and topics but build up that discussion so it becomes second nature to discuss and re-inforce. But is vaping safe?
I have the same issue my daughter who is 17 sees nothing wrong with marijuana at all. I fear for her safety and everyone else. I tell her to stop and a bomb goes off. Please leave a comment below to contribute to the discussion. Only a few high-risk medications—such as warfarin, some forms of chemotherapy, and some sedatives—are administered orally. A far greater number can be delivered intravenously, e. General-purpose infusion devices can deliver IV medications at any rate within a 10,fold range 0.
For example, a missing decimal point or a double key press can result in a or fold overdose e. A clinician can easily confuse dose, flow rate, and bolus or loading-dose amounts.
A hour dose can be programmed to be delivered over 1 hour. Undesirable variability in IV medication practices further increases the risk of harm. A review of infusion safety system software datasets from more than individual hospitals revealed huge variability in drug names, concentrations, dosing units, dose limits, maximum infusion rates, weight limits, volume limits, and other variables. Thousands of medications are currently available, and more are being introduced every year.
Look-alike and work-alike drugs and drugs with sound-alike names all increase the possibility of error. The increasing complexity of the patient care environment, the high turnover rates among nursing staff, and nurses working in multiple settings further increase the risk of harmful medication errors. IV medication infusion errors are widespread. Aggregated data from IV safety systems in 18 hospitals documented that 1.
An ADE is especially likely to result with drugs, such as heparin, for which dosing errors have a low detectability. Despite the effectiveness of PCA for opioid administration, responses to opioids vary greatly among individuals, and significant hazards are associated with PCA therapy. The success rate for in-hospital cardiopulmonary resuscitation remains less than one in five patients. However, severe cases can be fatal.
A recent study of continuous respiratory monitoring found an incidence of RD based on desaturation consistent with previous estimates. However, the incidence of bradypnea was many orders of magnitude greater than the 1 to 2 percent widely reported in the literature. Capnographic monitoring—measurements of ventilation using respiration and exhaled carbon dioxide EtCO 2 —is particularly important because it can provide an earlier warning of respiratory depression than pulse oximetry SpO 2 in some patient populations.
Recognizing that not all medication errors have the same potential to cause serious adverse events, the team decided that first priority should be given to averting errors that pose the greatest risk of harm. The team established the following Infusion Safety Goals In the past, it has been difficult to use technology to help avert IV infusion pump programming errors. CPOE systems do not address this type of error, 4 and bedside barcode scanning alone is not sufficient.
For a continuous IV infusion that spans multiple nursing shifts, several clinicians might make periodic dosage adjustments based on laboratory results, protocols, or verbal orders that might not be included in the barcode system, which increases the possibility of programming errors.
For these reasons, in , the SJCHS multidisciplinary team identified implementation of an IV infusion safety system as the best initial approach to safeguard patients against high-risk medication errors. Nurses involved in reviewing the IV medication safety system actively expressed their support for its selection. Having a single interface for all modules simplifies staff training, reduces programming complexity, and increases ease of use.
This combination of features suggested a dramatically improved infusion system that promised a potentially significant reduction in infusion-related medication errors. The database standardizes concentrations, dosing units, and dosing limits for IV infusion medications, which also improves safety and efficiency.
Data analysis helps identify opportunities for improving IV medication safety and best practices. Following selection of the system, clinical experts from various patient care areas were designated as trainers. In a multitiered process, staff received training through expert sessions, skills labs, hands-on exposure, and an internet computer-based training module provided by the vendor.
As a result, nurses, pharmacists, and physicians realized the benefits of using the safety software to help prevent high-risk IV medication errors. In October , the new infusion system was installed on all units in our three-hospital health care system. Installation of point-of-care units and large-volume pump modules was completed within an 8-hour period. Hospital-wide implementation required no changes in nursing workflow, had minimal impact on productivity, and required no additional full-time employees FTEs.
Syringe pumps were added to the system in In July , an innovative harm-assessment tool was developed by the IV Medication Harm IndexStudy Group, which included physicians, pharmacists, and nurses, who are recognized patient safety experts. The index comprised three subscales: Totaled subscale scores ranged from 3. In , further safety improvements were achieved with expanded drug libraries and the implementation of wireless networking with system management capabilities.
Wireless networking allows pharmacy to remotely monitor any patient receiving an infusion outside pre-established limits and to quickly install software upgrades, revise best-practice datasets, and gather CQI data for analysis. The system was designed to supplement, but not substitute for, clinician monitoring. The combination of system components allowed monitoring of practice i.
Based on this evaluation, continuous respiratory monitoring of each PCA patient was made the standard of care. PCA and respiratory monitoring modules were implemented hospital wide in June Pharmacy and nursing originally had planned to purchase a pulse oximetry module for each PCA module. As a result, a capnography module was purchased for each PCA module, and pulse oximetry modules for use with selected patients. Hospital PCA policy was revised to require respiratory therapy to round on every PCA patient at least once per hour shift.
Respiratory therapy also developed a patient selection algorithm to help clinicians determine appropriate respiratory monitoring for patients. In addition, all patients are intermittently monitored for SpO 2. Patients with the following conditions are continuously monitored for SpO 2: Representative results include the following: Number of programming errors prevented by smart pump alert: January — June Medication Management Readiness Team analysis and informal interviews showed that the nursing staff has embraced the new system.
Knowing that patients will be more comfortable, have more energy, and do better increases nursing satisfaction. In addition, the common user interface for PCA and monitoring modules reduces training time and decreases the likelihood of error. Clinician assessments of patients receiving PCA therapy have been greatly enhanced by the availability of combined dosing and respiratory monitoring trend data, particularly for EtCO 2.
In some cases, capnographic data provided the only indication of respiratory depression. From January to June , expanded infusion safety systems recorded overdoses greater than 1. Practice improvements based on analysis of CQI data from the IV infusion safety software include the following:. A collaborative approach is key to improving patient and medication safety. The team conducted comprehensive analyses, from the information-gathering stage through final price negotiations.
Involvement of nursing in research and implementation of the technology resulted in a high level of nursing acceptance and compliance. Focus on highest risk errors. Identifying and averting errors that have the highest risk—i.
Implementation of IV infusion safety systems has immediate, measurable impact on helping avert high-risk medication errors. Implementation also results in practice improvements, increased interdisciplinary communication, and improved nursing satisfaction, retention, and recruitment. Continuous respiratory monitoring of PCA therapy. When PCA pumps are involved, the risk of harm is more than 3. For this reason, the use of respiratory monitoring, especially capnometry, is important for patients receiving PCA therapy.
Continuous SpO 2 and EtCO 2 are important clinical parameters and should be used in conjunction with each other. SpO 2 reflects oxygenation, while EtCO 2 reflects ventilation; one may be normal while the other demonstrates an abnormal respiratory status. Noncritical care nurses and physicians are generally unfamiliar with the information provided by these devices and might have problems applying the data to the care of the patient. Because of this unfamiliarity, nurses are sometimes reluctant to call physicians when the system alarms.
Respiratory therapists may be needed to interpret the data. Ongoing analysis of CQI data. Analysis of CQI data is useful to identify opportunities for practice improvements and to target medication safety efforts. Importantly, the software in the IV safety system provides not only interdiction of untoward events but also information.
Analyzing the CQI data from all devices allows the multidisciplinary team to identify further opportunities for best practice improvements. Wireless networking and multidisciplinary collaboration allow implementation of those improvements efficiently and effectively, providing continuous safety improvement for patients and clinicians.
The harm and costs averted using this technology are substantial. There is little doubt that morbidity and mortality have been reduced because of the investment in this system. Patients not in critical care units are usually more hemodynamically stable, receive fewer IV infusions, and are typically perceived to be at lower risk of infusion-related errors. Findings from the IV Medication Harm Indexchallenge this perception, particularly when anticoagulants, such as heparin are being infused.
Data analysis showing that more than half of the most serious averted errors were associated with patients outside the ICU supports the importance of using IV safety systems for critical care and non-critical care patients. This system demonstrated immediate improvement in the care of patients receiving PCA, as evidenced by multiple cases during the first months of use.
Pulse oximetry and capnography with PCA prevented potential harm in these labile patients, decreasing the need to admit or transfer them to higher acuity departments, such as a step-down unit or ICU. The achievements of the SJCHS Infusion Safety Initiative have further strengthened our culture of safety and confirmed the importance of multidisciplinary collaboration.
Infusion safety technology now helps clinicians identify and, most importantly, avert the medication errors associated with the greatest risk of harm—IV administration errors at the point of care. Using wireless technology, staff can remotely monitor all infusions in both hospitals.
Trend data from respiratory monitors can be used to help avert PCA programming errors and monitor patient responses to opioids. IV infusion safety system implementation provides a rapid, effective, and cost-effective means to improve patient safety and quality of care. Turn recording back on. National Center for Biotechnology Information , U. Intravenous Infusion Safety Initiative: Author Information Authors Ray R.
Patient Controlled Analgesia Despite the effectiveness of PCA for opioid administration, responses to opioids vary greatly among individuals, and significant hazards are associated with PCA therapy.
The team established the following Infusion Safety Goals 4: Implement an error-detection system with built-in feedback loops, so that continuous quality improvements CQI could be made over time. Table 1 Examples of averted programming errors. Wireless Networking, Expanded Drug Libraries In , further safety improvements were achieved with expanded drug libraries and the implementation of wireless networking with system management capabilities. Standardization of decision-support drug libraries, including drug names, concentrations dosing units, and dosing limits across the two hospitals, as well as decreased complexity and opportunities for error.
Failure modes and effects analyses FMEA showed a 73 percent reduction, from to 56, in risk priority score for IV heparin therapy. Direct observation showed greater than 98 percent nurse compliance with the use of safety software that provides warnings based on the decision-support library.
From October to July , CQI data documented averted errors, including averted overdoses.
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information that FDA expects in a marketing application for a pen, jet, injectors are designed to provide an accurate method of injecting a dose of intended for use with a certain class/family of drugs or biological products, or with a should consider when developing a pen, jet, or related injector and submitting a. It takes several steps to prepare a medication for a patient; starting with a doctor's and finally the nurse's administration of the medication through an IV line. Spectrum IQ Infusion System with Dose IQ Safety Software can alert a nurse if Our premixed drugs and solutions are prepared with precision accuracy, and our . Do you take cream or sugar with your coffee? 20, , was expected to remove hemp and CBD from the Drug Enforcement The market for CBD products is anticipated to grow to more than $2 billion in total Tilray, Inc. TLRY, % is also currently developing a cannabis-derived epilepsy treatment.