Donation will help connect hospital’s IV pumps and electronic medical records
The IV “smart pumps” at Baxter Regional Medical Center will soon be a little smarter, thanks to a donation from Clark and Janice Fletcher of Mountain Home.
The hospital began using the smart pumps earlier this year to help dispense IV fluids and medication. The pumps get their “smart” name from their ability to calculate a proper dose based on a combination of a medication and a patient’s weight, a figure that nurses previously had to calculate by hand.
The Fletchers’ donation — made to the Baxter Regional Medical Center Foundation in the spring — will allow BRMC to develop a software interface so that its smart pumps can connect to the hospital’s electronic medical record (EMR) and update the patient’s history automatically.
“The negative part of electronic medical records is that the healthcare providers spend a lot of time at it. That takes time away — the human factor — from the bedside and away from the patient,” said Shannon Nachtigal, BRMC’s chief nursing officer. “What this is going to allow is instead of going back to the computer and charting how much fluid went in on that particular IV or medication, it will automatically flow over to the electronic medical records.”
In an ICU setting, it’s not unusual for an IV pump to be adjusted every 10 or 20 minutes, Nachtigal said.
“So, calculating what the intake is can be time consuming,” she said. “And now when a rate is adjusted, it will just flow over.”
The Fletchers said they wished their donation would be used to improve quality of nursing, but included no further instructions beyond that, deferring to the hospital’s judgement on how to best achieve that goal.
“We turned them loose with it,” Clark Fletcher said. “We told them, ‘We’ve got some funds and we want you to figure out how to spend it. We’re not going to put any input into it other than we want to improve quality of nursing, and you guys can choose how we do that.’ They didn’t have to clear it with us, just — when they could — tell us what they were doing with it.”
Administrators eventually decided to use the donation to develop the EMR integration feature on the hospital’s 400 smart pumps.
“We really wanted to do our due diligence,” Nachtigal said. “I can take a gift today and spend it tomorrow, but we wanted to really find something that would improve nursing quality and workflow.”
Nachtigal said that when planning the hospital’s budget, she had hoped to purchase the smart pumps in 2019 and then possibly double back the following year to develop the equipment’s EMR interface.
“With all the capital requests, I’m not sure how this (upgrade) would have fallen if we had not have had a donation. Well, I kind of know where it would have fallen,” she said with a laugh.
The hospital’s smart pumps are calculators on wheels.
“When I first became a nurse, we would have to calculate all our own dosages and calculate how fast or slow to run the pump at,” Nachtigal said. “Now the pump does that for you — you pick from a screen what medication you’re hanging and enter the patient’s weight and doctor’s order — and it calculates how fast or slow the pump needs to go. It’s a safety measure so you don’t underdose, which is sometimes almost as bad as overdosing a patient with medication.”
Once the smart pumps’ EMR interface is implemented, it will electronically connect healthcare providers, patients and the IV equipment.
“We scan the pump and the patient, so the EMR knows what equipment we’re using and what patient is using it,” Nachtigal said. “Then when the doctor puts in an order, that all automatically flows over to the pump.”
Even using a smart pump, an employee could enter the information for the wrong drug or get the patient’s weight wrong. Using the IV pump’s interface to pull that information directly from the EMR provides another level of safety for the patient.
“This will help prevent errors, and that’s the key thing,” said Barney Larry, BRMC’s vice president of business development and the executive director of the Baxter Regional Hospital Foundation. “An error here can cause something really bad. And then to be able to give these people more time to be hands-on at the bedside is so critical.”
The smart pump interface will also send information to the hospital’s medical administration records, documenting that staff have hung a particular IV fluid or a patient has received a particular antibiotic.
“When we first heard they were going to use the donation to improve the smart pumps, my first thought was, ‘Hey, smart pumps and smart people,’” Clark Fletcher said.
Adding the EMR integration to the smart pumps will not be an overnight upgrade, hospital officials said. The interface will have to be built in-house using a combination of computer technicians and hospital staff.
“It takes the techno people to build it and the nurses to explain to them how it will work in their area.” Nachtigal said. “ICU looks different than O/B, which looks different than Medical Surgery, which looks different than ER.”
BRMC has planned a Jan. 14 kickoff meeting for all the parties to begin collaborating on building the smart pump’s integration software. The hospital plans to have full integration between its EMR and its IV pumps by mid-to-late summer.
“It’s all about the IV system. It makes it better for the patients, safer for the patients and easier for the caregivers,” Clark Fletcher said. “For us, the process was really simple. We have a lot of trust in the hospital to do what is best with the donation. We’re tickled with how it turned out.”
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