Volume 8, Issue 1, June 2020, Page: 18-25
Optimizing Institutional Care of Implantable Intrathecal Drug Delivery Systems
Angela Kerins, Department of Pharmacy, University of Chicago Medicine, Chicago, United States
Randall Knoebel, Department of Pharmacy, University of Chicago Medicine, Chicago, United States
David Dickerson, Department of Anesthesiology, Critical Care and Pain Medicine, Northshore University Healthsystem, Evanston, United States
Magdalena Anitescu, Department of Anesthesia and Critical Care University of Chicago Medicine, Chicago, United States
Received: Feb. 21, 2020;       Accepted: Mar. 13, 2020;       Published: Mar. 31, 2020
DOI: 10.11648/j.ijacm.20200801.15      View  364      Downloads  49
Abstract
Intrathecal drug delivery systems (IDDS) have been a valuable therapeutic modality in the treatment of intractable chronic pain, typically reserved for cases where conservative pain management has failed. Given the high risk of this treatment and infrequent encounters with IDDS, it is essential to develop an institutional process to ensure the safe and effective management of patients. Our multidisciplinary team utilized healthcare failure mode and effects analysis (HFMEA™) to identify risks and redundancies in our current processes, subsequently implementing changes to prevent them. Risks identified included: handwritten orders, no standard order set, manual drug calculations, poor identification of IDDS upon hospital admission, and scarce nursing documentation of intrathecal medication. Following this step, our team incorporated tools and technologies to manage the more complex IDDS patients: standard order sets, computerized physician order entry (CPOE) systems, and computerized clinical decision support (CCDS) systems. Also, an excel calculator was introduced—seemingly the first of its kind in clinical practice—thus making the process more unique, thorough, and safe. There is a large body of evidence supporting the use of computerized physician order entry systems (CPOE) to reduce medication errors, and providing access to a computerized clinical decision support system (CDDS) at the time of prescribing to improve outcomes in patient care. Incorporating these tools into the management of IDDS patients is a significant opportunity to reduce risks and improve patient outcomes.
Keywords
Intrathecal, Pain Management, Quality Improvement, HFMEA
To cite this article
Angela Kerins, Randall Knoebel, David Dickerson, Magdalena Anitescu, Optimizing Institutional Care of Implantable Intrathecal Drug Delivery Systems, International Journal of Anesthesia and Clinical Medicine. Vol. 8, No. 1, 2020, pp. 18-25. doi: 10.11648/j.ijacm.20200801.15
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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