September 6, 2013
Hospital of the University of Pennsylvania
Bar Code Medication Administration Closing the Loop on Medication Safety Errors can occur in any part of the medication process – from prescribing to dispensing. That’s why, for the past several years, UPHS has implemented several measures to help reduce these errors and ensure patient safety. For example:
• Electronic order entry on Sunrise
eliminates mistakes due to illegible handwriting.
• Online clinical decision support guides
physicians to prescribe the best medication – and the right dose.
• Unit-based clinical pharmacists serve as active members of the medical team.
• PYXIS Profile ensures that patient meds
are verified by a pharmacist and that nurses remove the correct medication from the machine.
Inside Baby Clothes Drive a Success!..................................2 Exercise and Outreach: A Win-Win Situation.................3 Pari Tucker Wins CNA Spirit of Professionalism Award........3 New Bicycle Parking Rules in Effect.......................................4
Now a final step in the medication safety process – bar code medication administration (BCMA) – will close the loop. In the current process, the nurse first identifies a patient (confirming name and date of birth on information with the patient’s ID band). Then he or she reviews the electronic medication administration record (e-MAR) for what needs to be administered, gives the medications to the patient and signs them out on e-MAR. With BCMA in place, the nurse will scan the barcode on each of the medications before adminstering to the patient. Sunrise will verify the ‘five rights’ – right medicine in the right dose at the right time by the right route and the right caregiver. If any of these conditions are not met, “the screen will show an alert,” explained Terese Kornet, MSN, RN, director of Clinical Nursing Systems. Once the patient takes the medication, the nurse will click ‘done’ and the system will automatically update the patient’s medical
`` As Colleen Mallozzi, BSN RN, BSIS, manager of Nursing Informatics, demonstrates, each medication given to a patient will need to be scanned, as part of bar code medication administration..
record. In the current process, each medication must be keyed into the system individually.
Pharmacy’s Role: Making it Work Because bar code medication administration depends entirely on electronic scanning, getting the program up and running has been a complex process, said Paul Miranda, RPh, MBA, associate director of Pharmacy. To begin with, each dose of a medication order requires a bar code that Sunrise recognizes or it won’t work on the patient floors. As a result, “every wholesaler order we receive [each of which contains hundreds of medications] has to be manually scanned to confirm which are registered in the system and which aren’t.” (Continued on page 2)
(Continued from page 1)
Bar Code Medication Administration Closing the Loop on Medication Safety In addition, the bar code label must be legible. Miranda said this presents a problem on small items, such as syringes and small tubes of ointment, where the label is too big to fit properly. To resolve this issue, “we’re looking at a program that allows us to use a flag label. Its thin center can wrap around something as small as a syringe and provide a bar code suitable for scanning.” Pharmacy is also working to keep the number of required scans when dispensing the med to a minimum. The need to scan each dose given to a patient is one of BCMA’s safety features – ensuring that an entire order is given. For example, if a physician orders 100 mg of a medication but it only comes in 50-mg pills, the system would prompt, saying ‘One of two,’ waiting for the nurse to scan the second pill. However, Sunrise was built with common units, to simplify billing. In other words, if a patient needed 500 ml of a medication that came in 100-ml doses, the nurse would simply note the dosage on the computer. With BCMA, that order would require five separate scans. To keep the safety feature intact – but eliminate the need for multiple scans – “we’re trying to standardize common doses as much as possible,” Miranda said. “This isn’t a faster way to give meds. But it’s a safer way.” In addition to its safety benefits, BCMA implementation is required for UPHS to be eligible for Meaningful Use dollars, if certain criteria are met. Meaningful Use dollars are incentive payments from the Centers for Medicare and Medicaid Services for appropriate use of certified electronic health records. Kornet said that Founders 12 and 14 will pilot the program at HUP this month. If all goes well, it will be expanded to other units throughout the hospital.
`` Helping in the baby clothing drive were (l. to r.) Rick Heuser (Social Work), assistant nurse manager Kelley Karp, Caitlin Dibileo (Drexel Co-Op), Rhonda Nichols, Janeen Cross (Social Work), and Elizabeth Mooney.
Baby Clothes Donations Exceed Expectations! “Our hospital-wide clothing drive was a huge success!” That’s the message Rhonda Nichols of the Intensive Care Nursery passed along to coworkers after collecting far more baby clothes – preemies to 12 month sizes – than her goal of 400 outfits. In fact, the donations so outpaced her expectations that she was not only able to supply 18 bags of new and gently used clothing to parents in need on her unit – “It helps to lift the moral of preemie parents” – but also donated clothing to the Jane Addams House, a woman’s shelter, and the People’s Emergency Center. “And I still have three big bags filled with clothing,” she said.
“I see great things happening through these donations. I thank everyone for their support.”
I want to tell you what a wonderful experience my mother is having on 14 Founders. She came in emergently from a skilled nursing facility where she was overmedicated, on oxygen which she never was in her life, constipated to the point that her belly was very distended, and in a great deal of pain physically and emotionally. Mom broke 4 of her pelvic bones two weeks ago. She was independent and healthy and active until her fall [which] has thrown her into a tailspin and a pretty deep depression. Her nurses [Jamie Acero, Alex Brooks, Diana Santangelo] along with the CNA’s have been the most awesome, caring, intelligent, warm, compassionate people that I have ever met. My mother is smiling and
talking again and eating again as well, for the first time since her fall. Diana changed mom’s goals to ones that were more manageable and achievable which seems small but when you are stuck in bed it made my mom’s day to reach a goal. The nurses and other members of your team have made her feel like a whole person when they take care of her needs. The nurses NEVER make you feel like you are bothering them. Your staff has been respectful and they go above and beyond the “call of duty” to take care of the patients on their floor. I cannot say enough good things about everyone. I also have to say that environmental services and food services have been excellent.
Pari Tucker Wins CNA
Spirit of Professionalism Award Do You Have An Award-Winning Project?
This year’s CNA award for Spirit of Professionalism went to Pari Tucker of the CICU. According to her nomination letter, she is “an extraordinary CNA with a high level of enthusiasm.”
Each year, the UPHS Quality and Patient Safety Awards recognize departments throughout the Health System that have exhibited leadership and innovation in activities that ensure high-quality clinical outcomes, patient satisfaction, patient safety, and cost efficiency. Applications for the 2013 Awards will be accepted through September 30. For more information about the awards and the application process, go to http:// uphsxnet.uphs.upenn.edu/ceqi and click on “2013 Quality and Patient Safety Award.”
Tucker “values lifelong learning by consistently inquiring about how she can improve her practice. She frequently asks questions to try to familiarize herself with new procedures so she can better serve her patients. Ms. Tucker is self-motivated and pro-active in her clinical practice … always one step ahead of the clinical nurses in taking vital signs and performing hourly rounds. Ms. Tucker has a special way of making patients and families feel welcomed and equal partners in care.” Tucker is “conscientious with her patient care delivery which is evident in her interactions with the patients and families, through her documentation in KBC, and positive feedback from patients during leadership rounds and in the Press Ganey Surveys…. Her pride and commitment to world-class care is evident in her daily practice…. [She] is a conscientious, compassionate and diligent CNA.”
Exercise and Outreach: A Win-Win Situation Want to get great exercise and help others as well? Participate in Penn Medicine team-based activities coming up later this month.
5K for the IOA & Memory Mile Walk
Bike MS City to Shore
Saturday, September 14
Sunday, September 22
Saturday and Sunday, September 28 and 29
Help raise awareness about colon cancer in a 5K run/walk. A portion of this year’s proceeds will go to the Abramson Cancer Center’s West Philadelphia Gastrointestinal Health Outreach and Access Program, which helps West Philadelphia patients complete their screening colonoscopies – a powerful way to prevent colon cancer!
Run or walk through beautiful Penn Park with its skyline views of the City and help support Penn’s Institute of Aging for the treatment and care of patients with Alzheimer’s, neurodegenerative and other age-related diseases.
Join the Penn team on what has been named the ‘best cycling getaway’ in New Jersey and help raise money for multiple sclerosis. The team welcomes students, friends and family, and patients. Can’t ride? Be a volunteer!
To register, go to www.pretzelcitysports.com and click on ‘Online Registration’ in the left column. (Next issue: Read about an employee who will be running, biking and swimming in support of the IOA!)
bikepae.nationalmssociety.org and click on
To register or make a donation, go to http://bit.ly/18i3mQ3.
To learn more, go to
‘UPHS/Penn’ link on the right column.
Bonus: Members of Penn’s Wellfocused Healthy Rewards Program can earn 100 Healthy Rewards points for taking part in one of these events!
: Viewing Made Easier Thanks to mobile devices, access to the Internet is no longer confined to a desktop … or even a laptop. However, the transition to a very small screen is not always successful. According to Maggie Hampshire, RN, BSN, OCN, OncoLink’s managing editor, visitors to the site were missing features that weren’t readily visible on their smart phone screens. To overcome that hurdle, the OncoLink team used responsive web design so the site now automatically resizes to fit any screen. “It’s now so much easier to navigate from smaller devices,” she said.
They also took this opportunity to streamline the design. “It looks cleaner and is easier to navigate,” said Carolyn Vachani, MSN, RN, OncoLink nurse educator. To see the new, improved website, go to oncolink.org.
New Bicycle Parking Rules in Effect In an effort to more effectively accommodate the increase of bicycles at the University, bicycle corral parking is being created throughout the campus. Corrals reduce the potential for bicycle/pedestrian conflicts on the walks, improve security by providing video monitoring of corral locations, and enhance building access/circulation by removing the ad hoc placement of racks that has occurred over time. A new corral was recently completed in the yard of Blockley Hall across from Lot #44, and new corrals are being developed on Hamilton Walk and 36 Street. When the work is completed, bicycle parking near the Perelman School of Medicine will increase from 450 to 658. Bicycles may be parked at the following nearby locations: • South of Blockley Hall on • Johnson Pavilion entrance plaza on Curie Boulevard Hamilton Walk • North of Blockley Hall on Guardian Drive • Hamilton Walk and 38th Street • Stemmler Hall on Hamilton Walk • 36th and Spruce Streets Bicycles are restricted from HUP, the Perelman Center or the Smilow Center for Translational Research and are discouraged from being brought into University facilities. See a campus plan showing bicycle corral locations and capacities at http://www.facilities.upenn.edu/maps. For questions or concerns, please contact Bruce Kasprzyk at email@example.com or (215) 898-8760.
Helping People All the Time
Congratulations to April’s winners of the Helping People All the Time raffle. Lizi Abraham. . . . . . . . . . . . . . . . . . Silverstein 7 Karen Alvarez. . . . . . . . . . . . . . . . . Rhoads 2 Denise Bauer. . . . . . . . . . . . . . . . . Pharmacy Brittany Beckmann. . . . . . . . . . . . Rhoads 2 Guy Bodarky. . . . . . . . . . . . . . . . . . Respiratory Therapy Karen Boglin. . . . . . . . . . . . . . . . . . Staffing for All Seasons Amanda Calhoun. . . . . . . . . . . . . . Founders 14 Denene Dancey. . . . . . . . . . . . . . . Founders 9 Natalie Dimartino. . . . . . . . . . . . . Silverstein 10 Cordelia Freeman. . . . . . . . . . . . . Rhoads 2 Margerie Shayka-Grossman. . . Rhoads 2 Jordan Hecht. . . . . . . . . . . . . . . . . Founders 12 Stephanie Hook. . . . . . . . . . . . . . . Silverstein 10 Pamela Jackson. . . . . . . . . . . . . . Admissions
Lyndsay James. . . . . . . . . . . . . . . . Patient Accounting Nicole Jones . . . . . . . . . . . . . . . . . Rhoads 2 India Kearney. . . . . . . . . . . . . . . . . PGR Ambassador Ashley Kilgoe. . . . . . . . . . . . . . . . . Ravdin 6 Vincent Kopczynski. . . . . . . . . . . Security James Mahoney. . . . . . . . . . . . . . Radiology William Miller. . . . . . . . . . . . . . . . Respiratory Therapy Alexandra Mooney. . . . . . . . . . . . Radiology Valerie Pearsall. . . . . . . . . . . . . . . Ravdin 6 Patricia Poderis. . . . . . . . . . . . . . . Founders 1 Robersine (Robbie) Robinson. . . . Rhoads 2 Kevin Savage. . . . . . . . . . . . . . . . . Tele Transport Donna Marie Schuele. . . . . . . . . Rhoads 2 Minh Tran. . . . . . . . . . . . . . . . . . . . . Rhoads 2 Alexis Weaver. . . . . . . . . . . . . . . . Tele Transport
All Employee Meetings Learn more about HUP and the Health System by attending an All Employee Meeting. HUP leaders will provide up-to-date information and answer your questions. The next three will be held in Medical Alumni Hall on 1 Maloney on: Wednesday, September 11 5:00 to 6:00 pm Wednesday, October 9 8:30 to 9:30 am Wednesday, November 6 Noon to 1:00 pm.
HUPdate Editorial Staff Sally Sapega Editor and Photographer Julia Fiorello Designer
Susan E. Phillips Senior Vice President, Public Affairs Contact HUPdate at: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 email: firstname.lastname@example.org
HUPdate is published biweekly for HUP employees. Access HUPdate online at http://news.pennmedicine.org/inside/hupdate.