James Waterson

BD EMA, UAE

Title: Creating Lighthouses: Can Remote Technology Help Raise Standards of IV-Medication Administration Safety in Low- and Middle-Income Countries?

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Biography

James Waterson in a UK registered Nurse and has specialist certificates in Children’s Critical Care, Offshore Medicine and in Renal Nursing. He received his Baccalaureate from the University of London and has Master’s Degrees in Medical Education from the University of Dundee, and in Health Economics and Pharmacoeconomics from Pompeu Fabra University School of Management, Barcelona. He has published papers on medication safety, alarm fatigue, machine learning, medical device interoperability, introducing robotics into compounding and dispensing units, on leadership during disaster activation, and on managing critically ill pediatric patients in adult facilities. He has worked in Europe, the United States, the People’s Republic of China, and in the Middle East in clinical positions and in university faculties. He is an associate editor for the Journal of Medical Internet Research. He is currently the Senior Medical Affairs Manager for Medication Management Solutions, Becton Dickinson, for the Middle East and Africa.

Abstract

Objectives and Scope: Across low- and middle-income countries (LMIC) smart IV-infusion technologies are poorly adopted due to the sizeable capital spends for equipment, and because of limited local expertise in the effective implementation IV-medication safety technology and strategies. It is possible to bridge some of this knowledge gap by using remote technology to create, edit, and deploy smart drug libraries remotely and to obtain external expert review of data drawn from smart infusion devices.

 

Methods: Using Wi-Fi connected IV-smart pumps and remote access to hospital servers we deployed IV-medication libraries for neonates, pediatrics, and emergency room attendees and intensive care centralized infusion monitoring for intensive care areas to a 150-bed facility in Côte d’Ivoire. The libraries were created using best-practice processes and localized for use in the formularies of facilities in Côte d’Ivoire. Critical short-half-life medications were identified and marked out for central infusion monitoring.  

 

Results: Assessment of the effectiveness of the strategy was made via smart pump logs indicating compliance, reaction times for critical short-half-life medication interruptions, and dose-error “good saves”. In negotiation with nursing, pharmacy, and medicine representation within the facility we effected changes under a Plan-Do-Check-Act (PDCA) process that improved compliance with drug-library usage and improved protection for IV-medication error and alarm fatigue. Having remote access to the smart pump data allowed for expert review from established medication safety technology users from Europe and the Middle East.

 

Conclusion: Smart infusion technology benefited patients and clinicians given the improvements in safety identified in the study. The creation of ‘lighthouse’ facilities with a powerful culture of risk management for IV-medication error can positively influence lower-level facilities within their regions.