Improving medication events using Guardrails Suite ... - CareFusion

Great impact on improving
Great impact on improving
medication events in the
medication events in the
shortest amount of time
shortest amount of time
City of Hope case report
City of Hope case study
“Our nurses really embraced the change to the Alaris ®
System. This allowed us to introduce culture change
in incremental steps and to achieve the greatest impact
on improving medication events in the shortest amount
of time. We were able to adapt the data set to our
chemotherapy needs and still maximize the
safety features.”
Sharon K. Steingass, RN, MSN, AOCN
Director, Clinical Practice and Professional Development
Alaris ®

City of Hope
City of Hope National Medical Center, located just northeast of Los Angeles in Duarte,
California, is a most unusual and remarkable place—where compassion and leading-
edge care go hand-in-hand. Here, some of the world’s most knowledgeable physicians,
researchers, scientists and healthcare professionals join forces to treat—and to one day
cure —cancers and other life-threatening diseases. These distinguished experts provide
state-of-the-art patient care and also conduct leading-edge research.
Website: http://www.cityofhope.org
Address: 1500 E. Duarte Road
Duarte, CA 91010-3000
Smart pump technology is one of the medication safety initiatives adopted by the
City of Hope.
Honors, awards and special certifications
Joint Commission Accreditation with Commendation.
City of Hope has been named one of America’s Best Hospitals in Cancer and Urology
by U.S. News & World Report 2010-2011. Comprehensive Cancer Center, the highest
designation of the National Cancer Institute.
Founding member of the National Comprehensive Cancer Network.
Sharon Steingass
Sharon Steingass is a Clinical Nurse Specialist (CNS) for the Hematology/BMT transplant
service at the City of Hope National Medical Center. In this role, she is responsible for staff
education, and special project management for the hematology/BMT service line.
Sharon received her BSN from Capital University in Columbus, Ohio and her MSN at the
Frances Payne Bolton School of Nursing in Cleveland, Ohio. She completed a dual master’s
in nursing administration and oncology clinical nurse specialist. Sharon worked at the
UCLA Medical Center where she was Nurse Manager of the Bowyer Clinic; the USC Norris
Cancer Hospital where she was the Nursing Director for ambulatory care as well as other
community-based cancer settings. She received leadership and management awards at the
USC Norris Cancer Hospital and the City of Hope National Medical Center.
The Alaris System and
Guardrails ®
Suite MX software
Situation
City of Hope Cancer Center is one of the world’s leading
research and treatment centers for cancer, diabetes, HIV/
AIDS and other life-threatening diseases. Most medication is
delivered via intravenous (IV) infusion, which must be dosed
and administered correctly for effective treatment and patient
safety. IV programming events, which can result in significant
overdose, pose the greatest risk of patient harm. The most
important thing a hospital should focus on is averting IV
administration events.
When it was time to replace existing IV pumps, a
multidisciplinary team recognized that smart pump technology,
which can avert IV administration events, would have the
most rapid, significant impact on improving medication safety.
City of Hope chose to implement the Alaris System with
Guardrails Suite MX software before CPOE or barcode
technology due to the ability to implement safety technology
that met the organizational budget needs, and the ability to
implement within a short timeline without generating
other major organizational changes.
Following careful evaluation of the Alaris System and another
product, City of Hope selected the Alaris System as best
meeting their needs. The robust Guardrails safety software
allowed a Best Practices data set to be developed and adapted
to meet the hospital’s requirements, including Total Dose
protection and other unique chemotherapy protective safety
software features.
Ambulation is critically important for patients to regain
strength and stamina. The lightweight, modular design of the
Alaris System offers simple nurse-friendly pump programming
and makes ambulation easier for both patients and
transport personnel.

Key deciding factors
• Medication safety features, such as drug libraries and channel labels
• Ease of use
• Expandable platform that can accommodate other modules,
(e.g., monitoring modules, PCA modules and syringe pumps)
• Potential for future integration with other medication safety technologies
• Modular, lightweight design that meets patients’ mobility needs
Bone marrow transplant patients can have 10 or more IV lines running
simultaneously. The Alaris System can accommodate up to 12 lines using
three systems. The greatly reduced weight of the infusion system compared
to other products allows for easier ambulation.
Implementation
• The Alaris System with Guardrails software used hospital-wide
• The extensive data set customization required, as well as staff training, product
set-up and go-live installation, were accomplished in less than four months
• Installation was completed in approximately seven hours
Results
• Experience with the Alaris System with Guardrails software has
been very positive
• CQI data has been used by the medication safety team as one of the
measures to evaluate medication events within the organization; the
CQI data is used on City of Hope’s organization-wide Performance
Measurement Dashboard
• Informally, staff reports that they believe the new smart pump
technology has averted potentially serious medication errors
• City of Hope has also elected to add the Alaris PCA module
• Nurses find the system easy to use and the software to be
highly intuitive
• Both patients and transport staff report that the lightweight,
modular system makes ambulation much easier
• Patients have said they appreciate the additional safety features
of the new system

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San Diego, CA
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