SAFETY & COMPLIANCE
Infusion Pump Interoperability
in the OR
Revolutionizing Medication Administration
and Safety in the Operating Room
Overview
Codonics Safe Label System® (SLS), when combined with smart infusion pumps and Epic’s EHR system, has transformed the issue of infusion pump interoperability in the operating room (OR). Historically considered “out of scope” for anesthesiologists, this integrated solution now supports safe medication administration and auto-documentation, bringing the OR in line with hospital-wide standards for medication safety and compliance.
Challenges in the OR:
An Opportunity for Improvement
The operating room presents unique challenges when it comes to medication administration. Unlike other hospital areas where medications are administered following a written order and pharmacy review, in the OR, medications are often prepared by the anesthesiologist based on the patient’s condition at the time of surgery. This fast-paced, high-pressure environment can lead to vulnerabilities, especially when syringes are prepared without barcode labels or with incomplete labeling information, making charge capture difficult and error-prone.
Smart infusion pumps, which are critical for safe medication delivery, also present challenges in the OR. While infusion pumps in other hospital areas often communicate seamlessly with electronic health records (EHR) systems, OR pumps historically require manual programming, as there is no barcode system in place for anesthesia medications. This disconnect leads to potential human errors in medication delivery and documentation.
How Integration Works:
The Power of Interoperability
The integration of Codonics Safe Label System with smart infusion pumps and Epic’s EHR enables a revolutionary approach to medication safety in the OR. With this integrated triad—barcoded syringes, smart infusion pumps, and the Epic system—the OR now participates in a hospital-wide solution for medication safety, just like the rest of the hospital, delivering BCMA (barcode medication administration) for syringe or bag infusions.
At the point of care, SLS reads the barcode from the vial or ampoule, ensuring that the right drug and concentration are selected. Once the medication is drawn into the syringe, SLS prints a ready-to-apply, TJC-compliant label that includes the NDC barcode. This barcode can be scanned into Epic using the SLS-WAVE “hands-free” scanner or any compatible handheld scanner, allowing real-time documentation of the drug and concentration directly into the patient’s anesthesia record.
Streamlined Workflow in the OR
The integration between SLS, smart infusion pumps, and Epic enables a bi-directional workflow that simplifies processes and enhances safety.
This streamlined process reduces manual clicks, ensuring that clinicians spend less time on administrative tasks and more time focused on patient care. The pump’s interaction with Epic ensures that each titration or change made to the infusion is automatically captured in the patient’s record.
STEP 1
Scan Syringe:
The syringe label barcode is scanned, automatically documenting the drug and concentration into Epic.
STEP 2
Scan Pump:
The clinician scans the infusion pump
barcode to program it automatically.
STEP 3
Enter Order in Epic:
The anesthesiologist enters the order
(in just 3 clicks) for the medication, including dose, rate, duration, and volume,
directly from the Epic system.
STEP 4
Confirm and Start Pump:
Once the order is confirmed,
the pump is automatically programmed
and starts infusing.
Workflow Benefits for Pharmacy and Anesthesia
For Pharmacy:
- Accurate, Automated Documentation: NDC is automatically documented for charge capture and 340B compliance.
- Standardization Across the Organization: This integration helps establish hospital-wide standards for medication administration, supporting BCMA.
- ROI for Pharmacy: Automatic charge capture and 340B accountability drive real ROI by improving billing accuracy.
For Anesthesia:
- Safe Operation: Automatic infusion pump programming eliminates manual errors and ensures accurate dosing.
- Fewer Clicks: With less manual input required, clinicians save time and reduce the potential for errors.
- Real-Time Documentation: Automated documentation occurs once the infusion starts, with all changes (e.g., titrations) reflected in the patient’s record without provider interaction.
Once the syringe is scanned and the pump is programmed, all subsequent interactions with the pump—whether titration or changes to the infusion rate—are automatically documented in Epic. This reduces the risk of missed documentation and ensures accurate, real-time data on medication administration.
Safety & ROI: Enhanced Patient Outcomes
By improving interoperability in the OR, Codonics SLS integration with smart infusion pumps and Epic leads to enhanced safety, better patient outcomes, and improved communication during the transition of care. The ability to electronically document orders, program pumps, and track medications from preparation to administration increases efficiency, reduces human error, and streamlines the anesthesia workflow.
Meets ISMP Guideline 6.6: Implementing Bidirectional Infusion Pump Interoperability
Codonics integrated solution meets ISMP Guideline 6.6, which calls for the implementation of bidirectional (auto-programming/documentation) SMART infusion pump interoperability with the EHR. This solution enables safe medication administration and supports BCMA across the entire hospital, providing significant improvements in both safety and operational efficiency.
APSF Recommendations: Ensuring Safe Medication Practices
The Anesthesia Patient Safety Foundation (APSF) recommends that every anesthetizing location have mechanisms in place to identify medications and provide feedback, decision support, and documentation. Codonics Safe Label System, combined with interoperable smart infusion pumps and Epic, fully supports this recommendation, offering a comprehensive solution to improve medication safety in the OR.
Safety and Compliance Benefits
