Pharmaceutical supply in hospitals is not only a highly complex process, it is also still largely paper-based and therefore highly error-prone. Communication across sectors e.g. via outpatient-inpatient interfaces can lead to problems and breaks in information time and again. The digitalization of the medication process is therefore an essential component in promoting drug therapy safety.
Various drug therapy safety services can be used inn the medication module of RECOM-GRIPS, such as from ID Medics, as is illustrated here as an example integrated in GRIPS.
In the medication of RECOM-GRIPS, a phonetic search is integrated, i.e. spelling errors are tolerated and already written similar keywords are found and suggested.
The search includes:
Medications with trade names (products)
Active ingredient classes
Pharmaceutical registration number
Within the search, you can also directly enter a quick order with the search keyword e.g. "trama:101" (see screenshot). The quick order separated from the keyword by the colon based on a dosing schedule is transferred directly to the order, to be seen in the right window in combination with the ordered medication. The time period of a medication order can be conveniently and efficiently defined using quick planning buttons, e.g. +7 days. The resulting timeline can be displayed directly as a classic time scheme including orders.
When the medication is opened, the drug therapy status is displayed as an overview of all orders made so far (severity the message is visualized using three colored levels yellow, orange, red). In addition, next to each individual medication ordered, you get its status in detail. It is recognizable at first glance, whether, for example, there is a dosage error or even an overdose.
The integrated warning appears immediately with the selected medication. If this order is to be maintained despite a critical warning, a rationale must be entered in the warning window. Similarly, the order for a PRN medication or an antibiotic must be justified. The drug therapy safety check is also performed as part of a pre-check during the ordering process and therefore makes a significant contribution to preventing medication errors. In this way, newly prescribed preparations are checked in the context of already existing prescriptions. In this case based on the German medication database from ID Medics.
In addition, the following will be checked:
- contraindication (with reason)
- drug interactions
- drug allergies
- maximum dose
- administration time
- application duration
- drug level
- generic drugs
A check for possible allergies, e.g. based on the integrated history data is always part of a medication order (e.g. an allergy warning may appear as a result). In addition, factors considered to provide precise information related to the drug therapy safety check on demand include:
- present diagnoses
- breastfeeding status
- laboratory values
This makes a significant contribution towards patient safety. At the same time, there is no “over-alerting” by the integrated drug therapy safety check. The final decision on which warnings are considered is configurable in the system.
The medication module provides you with a split screen, which is divided into order area and medication of the selected patient case, a work area that meets all practical requirements in terms of clarity. You can see the entries you made parallel and in real time in the order area. This means that at the first click the drug appears as a preview, but can also be deleted just as easily with a click. At the same time, the drug therapy safety statuses appear directly for each drug and this patient case.
Helpful icons are displayed within the medication module, which visualize at a glance details about a selected medication. For example, you can see if the drug is from the house catalog, if and how it is divisible, crushable, or suspendable, and how it is administered. The medication module also includes a clustering for each drug indicating in which form of administration it is available, e.g. injection, tablet, infusion, etc.
If, for example, you choose the form of administration infusion, it can be composed of different components in a completely variable manner. The highlight: once infusion components have been created and are frequently used, they can be named and saved as a template and thus prescribed again and again by quick selection. Individual adjustments can always be made for the patient case without changing the template. In addition, it can be defined for which ward the template should apply or whether it should also be assigned to a specific topic, e.g. thrombosis therapy. The user and rights concept linked to the login enables template creation for certain user groups and key users only.
RECOM-GRIPS offers you the option of ordering an additional PRN medication, e.g. for pain, within the single medication already prescribed for a selected patient case. Here, too, you can use the quick search to access the list of medication and select, e.g. the form of administration drops from the categories. Within the dosage regime and the selection “maximum dose if required” you get to the ordering window and to specify which minimal and maximum doses may be administered per day. Each administration is in turn documented with automatic warnings notifying when quantities do not correspond to the order.
The legitimation of an order is ensured by given mandatory fields. A necessary specification is, for example, the reason for the administration of PRN medication. The time periods can again be defined via a quick entry window.
Different order variants such as an infusion with another order mode can also be displayed. Within this particular order process there is an automatic conversion of different volumes of the order quantities. Quantities of different infusion components are coordinated in this way.
In addition, you make the decision how, for example, the infusion should be administered, via syringe driver, infusion pump or normal drip infusion. Additional time specifications in interval, flow rate, pauses, system changes or bolus specifications can be easily ordered and are clearly displayed in the time bar.
Via quick information detailed information about the medication can be viewed directly at the point of care, in this example via the integration of ID Medics. Due to the connection to the ABDA database the verified information is available for review at any time.