“Say goodbye to iatrogenic grief”

Posted: July 13, 2010 in Uncategorized

         I found the following information on the internet:

       ” Patient injuries resulting from drug therapy are among the most common types of adverse events that occur in hospitals.9 Although the incidence of ADEs (adverse drug events) and their effect on costs have been investigated in only a few hospitals in the United States, the implications are clear from published results that ADEs constitute a widespread problem that causes injuries to patients and disproportionately increases expenses.”

    

       The medical profession sometimes does not give one a second chance after an error is made.

      I foresee a medical paradigm in which the worlds of computer science, pharmacology, government regulation, nano-technology, nursing care and biomedical engineering collide to erase a nurse’s grief due to adverse medication events.

    The technology exists for FDA regulators to require pharmacologic bar-codes on bottles of medication which reflect the medication’s name, refractive index, specific gravity, osmolarity, osmolality, dosage, strength, route of administration etc.

      The method of delivery of  parenteral medication has not changed in years. Why couldn’t the computer laptops you will learn about in later posts on this blog be also used with infrared or laser barcode sensors to read the barcode of each bottle and consequently further infra-red or laser sensors attached to the neck of each bottle of medication by the caregiver reads the diameter, length, refractive index, specific gravity (perhaps also incorporating the colorimetric methods used by blood chemistry analyzers), etc.  of the medication in the syringe as the medication is drawn up?  Medication syringes that are marketed with the medication already in the syringes are scanned in a similar manner by portable infra-red or laser barcode and medication chemistry scanners. The name of the manufacturer of the syringe and other parameters would be entered in the software of the laptop computer so a warning can be given if the parameters measured in the medication syringe does not match the parameters in the software in the patient’s electronic medical record for the medication ordered by the physician. The software in the computers can also alert the nurse if the medication is being given at an unusual interval from manufacturer guidelines, or if the EMR for the patient lists an allergy  for the medication. The use of electronic medical records by the caregivers will facilitate this idea.

     These safeguards can also alert the caregivers if the medication in the syringe contains a drug that has not been premixed well (Perhaps this may be one reason for divergent measured refractive indices and/or specific gravities detected by the computer software.)

     Other similar methods can be devised to warn the care-giver if the per- os medication does not match the physician’s orders for the patient.

      Liquid medication that is required to be given orally cannot be  given parenterally because the laser or infrared beam from the microsized chemistry sensor attached to the oral medication delivery container is large enough to sense an attached needle. The computer then will give an alarm, both auditory and visual.

     Perhaps the cost of developing and using this technology would be offset by the decreases in liability insurance premiums paid by hospital management.

     This patient care idea is also useful in the veterinary paradigm.

   

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