Establishing structured processes with multiple safety checks to manage IV room workflow is essential to improving medication safety. The purpose of redundant safety checks is to prevent errors that occur as technicians and pharmacists strive to dispense medications in a timely fashion. Errors that originate in the IV room include incorrect preparation of sterile products (e.g., wrong drug amount, wrong product concentration, etc.), products that were prepared correctly but ordered incorrectly (e.g., over-concentrated medications, use of incorrect diluents, etc.), preparation of sterile products in an unsterile environment, and general failure to comply with the proper steps of medication preparation (e.g., neglecting to filter components during preparation of intrathecal products). In addition to these commonly reported errors, many pharmacies still rely on the practice of having a technician pull back the syringe to indicate the amount placed into the IV solution as a safety check. While a long-standing method, it relies on the inherently fallible elements of trust and training, and is rarely accompanied by any concrete documentation other than that which is written by the technician.

Workflow Management Solutions
The essential challenge of managing workflow in the IV room is determining how to build safe processes while maintaining efficiency of dose dispensation. Current options for improving IV room processes include the employment of robotic IV preparation devices, ready-to-use unit dose products, pumps and software to manage the intricacies of total parenteral nutrition preparation, batched preparation of standard medications, standardized medication administration times, standardized concentrations, and routine technician responsibilities outlined in policies and procedures. However, none of these options provide comprehensive solutions for overall workflow management or have the ability to verify exact amounts and types of medications given in the past. A relatively new technology, IV workflow management products, such as chemocato and DoseEdge, fill this void by managing all aspects of sterile product preparation. The use of an integrated solution to manage workflow is essential for improving medication safety in the IV room because the potential for error in sterile product preparation exists in every step of the process. The continuous efforts of health care organizations nationwide to become compliant with USP Chapter in conjunction with workflow management products will create opportunities for improved IV room medication safety in the future.

IV Workflow Management Technology

Baxa Corporation visit www.baxa.com/doseedge

DoseEdge (formerly IntelliFlowRx)
DoseEdge offers an integrated system for managing IV and oral dose preparation activities. Using DoseEdge, health system pharmacies can streamline the steps for preparing and documenting critical patient doses through:

• Real-time status of incoming and in-process doses
• Bar code drug verification and dose tracking
• Automatic dose calculation
• Best-practices approach for pharmacy workflow
• Remote inspection of pharmacy preparation steps

DoseEdge helps to prevent medication errors, reduce waste from lost and missed doses, and ensure timely filling and delivery of IV doses.

Chemocato LLC visit www.chemocato.com

chemocato
Chemocato is a modular software solution for chemotherapy that coordinates communication between physicians and pharmacists, providing support through all stages of therapy including long-term therapy planning, ordering, monitoring, preparing, and dispensing. The software controls preparation of cytotoxics via an electronic scale connected to the computer. Step-by-step onscreen instructions and dosage checks by an electronic scale guarantee accuracy. The planning, ordering, and production of each medication are automatically documented. Bar code scanning during preparation and administration provides an accurate method of chemotherapy delivery. Features include automatic dosage calculations, pop-up warnings, preset regimens, and automatic documentation.

Alexander T. Jenkins, PharmD, a senior pharmacy administration resident at the University of North Carolina Hospitals, will take on the role of manager and medication safety officer at WakeMed Health & Hospitals' Raleigh campus in July. Alexander earned a BS from the College of William & Mary and a doctor of pharmacy from the University of North Carolina at Chapel Hill.

Stephen F. Eckel, PharmD, BCPS, received his BS and doctor of pharmacy from the University of North Carolina at Chapel Hill and his master's of health care administration from the UNC School of Public Health. Stephen is an assistant director of pharmacy and the residency program director for UNC Hospitals. He is responsible for managing all adult, pediatric, and ambulatory clinical services. Stephen is board certified as a Pharmacotherapy Specialist.

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