idosecheck visualize safety jacqueline ellis, rn, phd stephanie langford, rn, med powered by...
TRANSCRIPT
iDoseCheck
Visualize Safety
Jacqueline Ellis, RN, PhDStephanie Langford, RN, MEd
Powered by Clinical Evaluation Online (CEO) Inc
Problem• Drug calculation errors common and deadly
– 5 and 10- fold errors range from 6% to 15% of reported pediatric drug errors– morphine most commonly associated with error
• Specialty pediatric hospitals not immune to errors– 6,000 medication incident reports from SickKids (2004-2009)– 4% were 10-fold errors (240 errors) – patient harm noted in 22 cases– 18 errors were 100-fold overdoses
• Wrong dose errors occur in a global context– UK-study 5,000 incidents involving chemotherapy were analyzed (2003-2008)– 32% were wrong dose, including wrong strength (1600 errors)– 7 fatalities, 9 episodes of moderate harm and 9 episodes of severe harm
resulted from errors
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Problem
• Drug errors end lives and careers • Drug errors cost money • Lack of confidence with
calculations wastes valuable time
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Solutions
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Typical text based calculator
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Value Added Solutions
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Value Added Solutions
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Research ProgramStudy 1 A human factors approach to understanding medication errors related tointravenous morphine administration in a pediatric hospital (2009)
Study 2 Preventing Medication Errors with High Alert Drugs: Testing a Computerized Double Check (2009-211)
Research Team
Business Team
connected networks
relevant experience
contextual knowledge
manage information
people, money
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Vivian Joseph Mathews, BEngJacqueline Ellis, RN, PhDStephanie Langford, RN MEd
Thank YouQuestions?