Appl Clin Inform 2021; 12(01): 065-072
DOI: 10.1055/s-0041-1722871
State of the Art/Best Practice Paper

Development and Evaluation of an Intravenous Infusion Sequence Annotation System

Ji Qiu
1  Department of Pharmacy, Hefei Binhu Hospital, Hefei, Anhui, China
,
Tingting Deng
2  Sichuan Kelun Pharmaceutical Co., Ltd, Chengdu, Sichuan, China
,
Zhuo Wang
3  Department of Pharmacy, Shanghai Changhai Hospital, Shanghai, China
,
Zhangwei Yang
4  Information Section, Shanghai Fourth People's Hospital, Shanghai, China
,
Ting Liu
1  Department of Pharmacy, Hefei Binhu Hospital, Hefei, Anhui, China
,
Yunjie Liu
1  Department of Pharmacy, Hefei Binhu Hospital, Hefei, Anhui, China
,
Rui Li
1  Department of Pharmacy, Hefei Binhu Hospital, Hefei, Anhui, China
,
Fu Dai
5  Hefei Binhu Hospital, Hefei, Anhui, China
› Author Affiliations
Funding The project was supported by the Key Research and Development Plan Project of Anhui Science and Technology Department (No.1804h08020276).

Abstract

Objectives The sequence of intravenous infusions may impact the efficacy, safety, and cost of intravenous medications. The study describes and assesses a computerized clinical decision support annotation system capable of analyzing the sequence of intravenous infusions.

Methods All intravenous medications on the hospital formulary were analyzed based on factors that impact intravenous infusion sequence. Eight pharmacy infusion knowledge databases were constructed based on Hospital Infusion Standards. These databases were incorporated into the computerized sequence annotation module within the electronic health record system. The annotation process was changed from pharmacists' manual annotation (phase 1) to computer-aided pharmacist manual annotation (phase 2) to automated computer annotation (phase 3).

Results Comparing phase 2 to phase 1, there were significant differences in sequence annotation with regards to the percentage of hospital wards annotated (100% vs. 4.65%, chi-square  = 180.95, p < 0.001), percentage of patients annotated (64.18% vs. 0.52%, chi-square = 90.46, p < 0.001), percentage of intravenous orders annotated (75.67% vs. 0.77%, chi-square = 118.78, p < 0.001), and the number of tubing flushes per ward per day (118.51 vs. 2,115.00, p < 0.001). Compared with phase 1, there were significant cost savings in tubing flushes in phase 2 and phase 3. Compared with phase 1, there was significant difference in the time nurses spent on tubing flushes in phase 2 and phase 3 (1,244.94 vs. 21,684.8 minutes, p < 0.001; 1,369.51 vs. 21,684.8 minutes, p < 0.001). Compared with phase 1, significantly less time was required for pharmacist annotation in phase 2 and phase 3 (90.6 vs. 4,753.57 minutes, p < 0.001; 0.05 vs. 4,753.57 minutes, p < 0.001).

Conclusion A computerized infusion annotation system is efficient in sequence annotation and significant savings in tubing flushes can be achieved as a result.

Protection of Human and Animal Subjects

No human or animal subjects were included in this project. Our study was reviewed by our institutional IRB and deemed exempt.




Publication History

Received: 22 August 2020

Accepted: 09 December 2020

Publication Date:
03 February 2021 (online)

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