Medication Errors
Dick Tracy device averts a myriad of errors
Eliminates 'I already told the other nurse all that'
Prescribers' illegible handwriting results in errors that account for 14% of reports submitted to the Practitioners' Reporting Network of the U.S. Pharmacopeial Convention (USP) in Rockville, MD. Paper charts are often hard to find - they may be at the other wing of the hospital - as well as being illegible and time-consuming to wade through. They also pose confidentiality problems. To address these concerns, you might want to look into purchasing a new device that looks like a wristwatch battery and that attaches to hospital patients' identification bracelets. The button stores complete medical records and replaces handwritten paper charts.
Researchers at the Medical University of South Carolina (MUSC) in Charleston have devised a portable computer memory disk the size of a watch battery. The disk attaches to the patient's wrist identification band. (See photo, p. 127.) Using lightweight hand-held personal computers, staff can enter many kinds of data into the disk, such as identification and demographic information, diagnostic information, drug allergies, the side of the body on which surgery is necessary, whether it's difficult to intubate the patient, medical history, physical examination, and a case synopsis including anesthetic and other drugs, doses, and complications.
The disk keeps a time log of events before, during, and after surgery. In a study run by Gary R. Haynes, PhD, MD, associate professor in the department of anesthesiology at MUSC, more than 34,000 successful data transfers were made using the system. Each transfer was done in four seconds or faster.
The wrist system can be an adjunct or alternative to networked workstations depending on an organization's size and needs. Most networked systems allow staff to access and update information only at predetermined locations.
The patient wears the disk from the time he or she enters the surgical unit, and doctors can up- or download data instantly. Patients aren't annoyed by having to repeatedly answer the same questions asked by different personnel. When the patient leaves the hospital, the data can be transferred from the disk to a conventional database for future analysis and studies.
Automate records cost-effectively
Paper medical records cost about 50 cents each and can be used only once. The portable memory devices cost under $10 and are reusable. "Our hospital is moving toward an electronic medical record," says Haynes. "We have 22 ORs, and a large-network system would easily cost us over a half million dollars." With that type of system, every station has to have a desktop-sized computer and all that goes with it. Palmtop computers can cost as little as $300 each, so the overall cost depends on how many you would need. "Twenty plus a few hundred buttons would cost a hospital a fraction of the cost of a large system," says Haynes.
In addition to instant accessibility, the data can be analyzed following discharge for quality assurance studies on operating room efficiency, drug usage, and other indicators. "The device can eliminate the QA sheet containing quality indicators, possible complications, and so on. All that is incorporated in the chip," says Haynes, lead researcher on the device.
"There's less continuity of care now for surgical patients," says Haynes. "What we used to do was go to see patients the day before surgery, interview and educate them about what was going on, and do our evaluation. That's all out the window now in this era of cost-containment. With more and sicker patients, they see different caretakers from point to point along the assembly-line-type process." Because of that, clinical information is not always passed along as clearly and accurately as it should be. And, with hospitals trying to work more efficiently and reduce costs, they are increasingly interested in ways to accurately track patients to determine turnover times, such as knowing how long they are in the holding rooms and ORs.
Called WristRecord, the system is distributed by Ichor, North Charleston, SC. For more information, contact [email protected]. Ichor's Web site is http://www.ichorcorp.com. Telephone: (803) 529-0045.
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