HOSPITAL PRACTICE

New system offers last defense against IV errors

A pilot test of a new bedside system that prevents IV drug errors has been completed at the Mayo Foundation for Medical Education and Research at St. Mary's Hospital in Rochester, Minn. Results of the test, which was conducted in one unit of the hospital involving about two dozen beds, are expected next February.

According to Peter L. Elkin, M.D., associate professor of medicine and medical informatics at Mayo Medical School, the system, called PatientGuard, seems to "do what it says," that is, provide a last chance to catch medication errors at the point of care before they happen.

Under the system, a nurse scans the bar coding on a patient's wristband, medication, and infusion pump to collect information to create a drug treatment profile. PatientGuard then sends this profile to a clinical content database to check for drug-drug, drug-allergy, and drug-disease interactions. If an interaction is noted, that information flashes on the PatientGuard screen by the bedside. The information can also be sent to the pharmacy or a nursing station. Through this exercise, hospitals can make sure that the right patient is getting the right drug, right dose, and right rate of administration.

This technology is a collaborative effort of two companies—Catharsis Medical Technology, developer of PatientGuard, and Micromedex, which produces UltiMedex, the software decision support system. UltiMedex runs in the background, so users never see it. It provides answers within seconds to the interaction queries from nurses.

According to Elizabeth Mroz, founder and president of Catharsis, PatientGuard was developed after she almost died from an adverse drug reaction at a New England hospital years ago. "I didn't want what happened to me to happen to somebody else," she told Drug Topics.

PatientGuard serves as a safety net and last line of defense for patients before a drug hits their vein. All drugs administered by infusion pump are automatically and continuously monitored. The software can interface with any infusion pump and meets standard medical device communications protocols, she claimed, adding that oral and syringe drugs can also be entered into the system.

UltiMedex has two key advantages over other clinical knowledge bases on the market, claimed James Hickerson, strategic account executive at Micromedex. One is its ability to calculate a patient's specific dose by height, weight, serum creatinine, and other patient-specific criteria. The other is its ability to deliver an electronic version of the Physicians' Desk Reference.

According to Mroz, PatientGuard costs $300 per bed per month. "We call it a subscription model," she said, adding that one unit can be placed between two beds.

While commending PatientGuard for closing the loop on drug administration to patients, Mayo's Elkin cautioned that for this type of software to work, hospitals must have bar-coded medications on the floor. In the test Mayo just completed, Catharsis provided a book of codes for drug names and concentrations to be scanned, he said.

In the wake of the Institute of Medicine report on med errors, experts believe that, like computerized physician order entry, POC software that intercepts mistakes before they occur will be all the rage among hospitals in the next few years. Several products of this ilk have already been developed. Besides PatientGuard, hospitals can choose from Bridge Medical's MedPoint system and Alaris/ McKesson's GuardRails system, both of which were featured at the recent ASHP midyear meeting in New Orleans.

For more information on PatientGuard, call the Moultonboro, N.H., firm at (603) 253-7274 or check out its Web site at www.catharsismedical.com. Information on UltiMedex can be obtained from Micromedex, Englewood, Colo., at (800) 525-9083 or on its Web site at www.micromedex.com.

Judy Chi

Judy Chi. New system offers last defense against IV errors.

Drug Topics

2001;23:26.