Web-based system may cut medication errors

Nurses won’t need PDR to access key information

Researchers at Louisiana State University Medical Center in Shreveport are testing the effectiveness of an electronic information system that can instantly help ICU bedside nurses access clinical information about medications and related therapies without resorting to standard medical desk references or published clinical guidelines in book form.

If the system works as expected, a medical staff will be able to retrieve important non-patient specific information within seconds from other hospital departments and sources such as the health science library.

The system can be developed affordably to run on any hospital’s existing information system and can be accessed on any mini-workstation by nurses at the patient’s bedside, according to Steven A. Conrad, MD, ICU director at Louisiana State University Medical Center.

The technology is being touted as extremely useful in helping nurses prescribe and administer formulary medications with confidence about their dosages, effectiveness, and safety. If properly used, the system can significantly reduce medication errors and adverse drug reactions, a growing concern in many ICUs.

Much is being reported about advancements in the area of computerized patient records, but comparatively, there’s little being done in developing a non-patient repository of useful information that can save clinicians time in patient-care wards, says Conrad, the system’s developer.

Speed and convenience in accessing clinical information from practice guidelines and medical literature is especially important in settings such as the ICU and emergency department, Conrad says.

The system is similar to the Internet, except that it operates within a closed (Intranet) user network. Like the Internet, it allows a back-and-forth transfer that enables a user to request and retrieve information from an outside source in a Microsoft Windows format called WinDNA.

The information is then delivered in a speedy, uniform, easy-to-read format that can be accessed at a bedside terminal, known as a universal clinical workstation or a central workstation. The information travels on a local area network here called the SpaceLabs Medical Ethernet. (See chart, p. 21.)

Sitting at the workstation, a nurse can log on to access specific Web sites for medication and other practice guidelines. (The system also can access hospital-wide drug policies and regulatory and administrative directives.) The screen will show textual, graphic, and voice-overs regarding specific medications, their prescribed levels for certain patients, and safety concerns.

Early trials of the system involved only the MICU. Conrad is currently expanding the system to network with other locations hospitalwide and expects to expand the network in phases.

Sources

For more information on acute-care nurse practitioners, contact:

Therese Richmond, CRNP, PhD, director of the acute-care nurse practitioner program, University of Pennsylvania School of Nursing, 420 Guardian Drive, Suite 412, Philadelphia, PA 19104-6096. Telephone: (215) 573-7646. E-mail: terryr@pobox.upenn.edu.

Mary C. Smolenski, EdD, RN, CS, director of certification services, American Nurses Credentialing Center, 600 Maryland Ave S.W., Suite 100 W., Washington, DC 20024-2571. Telephone: (800) 284-2378. Web site: www.nursingworld.org.