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Development of A Decision Support Tool for Drug Infusion Performance Evaluation Poster Title: Risk-based Scoring Method for Overridden IV Infusions Wan-Ting (Kerina) Su1,2*, Poching DeLaurentis1, Mark Lehto2 1 Regenstrief 04/21/2016 Center for Healthcare Engineering, 2 School of Industrial Engineering, Purdue University Drug Infusion Performance Evaluation Cycle Smart Infusion Pump Drug Limit Library Define/Revise Drug Limits Program Infusion Parameters Update Drug Limits on Pumps Record Infusion/Alert Data Data START Evaluate Drug Infusion Performance Drug Limits What cause Issues? Workflow YES Other Nurse Improve Workflow Design Safety Issues? Improve Nurse Training NO Other (e.g. Improve Communication) STOP Administer Drug Infusions Analysis Tools • Global Measures: Key Performance Indicators (CareFusion) Infusion Pump Safety Score (Carlson et al., Intermountain Healthcare, 2015) • Global and Individual Measures: IV Medication Harm Index (Sullivan, 2004; Williams, 2006) CareFusion. (2016). Knowledge Portal for Infusion Technologies v2.10. Carlson, R., Johnson, B., & Ensign, R. H. (2015). Development of an “infusion pump safety score.” American Journal of Health-System Pharmacy: AJHP: Official Journal of the American Society of Health-System Pharmacists, 72(10), 777–779. Sullivan, J. (2004). IV Medication Harm Index: Results of a National Consensus Conference. In Infusion safety: addressing harm with high-risk drug administration (pp. 29–31). San Diego, CA. Williams, C. K., Maddox, R. R., Heape, E., Richards, H. E., Griffiths, D. L., & Crass, R. E. (2006). Application of the IV Medication Harm Index to Assess the Nature of Harm Averted by “Smart” Infusion Safety Systems: Journal of Patient Safety, 2(3), 132–139. Research Goal: Develop Decision Support Tool to Help Medication Safety Teams Evaluate Drug Infusion Performance Phase I: Individual Assessment Phase II: Global Assessment (each soft limit overridden infusion) (hospital system level assessment of infusion practice) RQ 1: How can risk score for each overridden alert be generated? RQ 2: What global risk measures for system evaluation can be defined? A Matrix-based Method (Huang and Moh, 2016) Refer to IV Harm Index Aim 1: Create Risk-based Infusion Score to exam overridden IV infusions Slim-Maud Method (Embrey et al., 1984) Aim 2: Estimate probability of ADEs for Risk-based Infusion Score Validation Aim 3: Generate a global risk measure (from Phase I) Interview & Observation Research Aim 4: Conduct Task Analysis to break down the tasks of System Evaluation Refer to KPIs, IP Safety Score, and Expert Knowledge Aim 5: Define all other global risk measures Phase III: Decision Support Tool Development RQ 3: How can overall risk be estimated? RQ 4: What medication-care unit combinations will be targeted as higher risk? Causal mapping approach to constructing Bayesian Network (Nadkarni and Shenoy, 2004) Aim 6: Derive causal maps (from phase II ) Estimate overall risk using probability encoding techniques Aim 7: Target the combinations of care units and highrisk medications (from Aim 6)