Mandating dose error reduction Free foot fetish dating with no sign up

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In this time, I have watched the evolution of the technology to control the delivery of IV fluids and medications from passive mechanical devices (some may remember, often fondly, the Dial-a-Flow device) to simple electromechanical infusion devices, to today’s so-called “smart” infusion pumps.

The pumps are called “smart” primarily because they incorporate “dose error reduction software” (or DERS) intended to identify drug dosages that fall outside individual facility defined best-practices ranges.

In a 2010 study, 73% of cases involving use of an IV pump had at least one dosing error.

The FDA obtains more than 10,000 infusion device-related adverse event (AE) reports annually, yet we know that than were reported over two years in that hospital’s incident reporting system.

An ongoing study led by David Bates, MD, at Brigham and Women’s Hospital in Boston, is also looking the issue of smart pumps and medication errors.

Reported AEs vary in severity, but many include significant patient injury and even death.

There are untold case reports in which clinicians made a simple usability error (e.g., misprogramming a pump to deliver a drug at ten times the intended rate) that caused irreparable patient harm.

Unfortunately, the clinician is often blamed for these device-related errors.

A string of recalls by the Food and Drug Administration (FDA), affecting nearly every major infusion pump company and receiving ample public attention, further suggests that current pump technology does not meet the safety and usability we should expect of high-risk medical devices.

Yet, how can so many well-intended, well-trained clinicians make so many rueful errors, undeterred by the provision of technology (DERS) specifically designed to prevent them?

The reality is that in addition to the technological (i.e., feature) deficiencies described in more detail below, the most prominent contributors to pump-related use errors are poor UI design in part related to a failure of vendors to employ a user-centered design (UCD) approach that incorporates a systems perspective and a thorough consideration of the myriad complex factors inherent in both routine and non-routine patient care.

Every surgical patient and nearly every hospitalized patient receives medications as well as fluids via the intravenous (IV) route. For example, in a 2005 study of hospitalized Australian patients receiving continuous IV infusions, there was an 18% incidence of error.

I have been practicing anesthesiology for more than 30 years.

A string of recalls by the Food and Drug Administration (FDA), affecting nearly every major infusion pump company and receiving ample public attention, further suggests that current pump technology does not meet the safety and usability we should expect of high-risk medical devices.

Yet, how can so many well-intended, well-trained clinicians make so many rueful errors, undeterred by the provision of technology (DERS) specifically designed to prevent them?

The reality is that in addition to the technological (i.e., feature) deficiencies described in more detail below, the most prominent contributors to pump-related use errors are poor UI design in part related to a failure of vendors to employ a user-centered design (UCD) approach that incorporates a systems perspective and a thorough consideration of the myriad complex factors inherent in both routine and non-routine patient care.

Every surgical patient and nearly every hospitalized patient receives medications as well as fluids via the intravenous (IV) route. For example, in a 2005 study of hospitalized Australian patients receiving continuous IV infusions, there was an 18% incidence of error.

I have been practicing anesthesiology for more than 30 years.

In a study we did for the FDA more than a decade ago, we categorized IV medication errors reported by 49 inpatient pharmacists and critical care nurses during eight focus groups.

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