title: Measures to improve safety of an elastomeric infusion system for pain management.
abstract: OBJECTIVE
  Measures to improve the safe implementation and utilization of an elastomeric infusion system for pain management are described.
  
  
  CONCLUSIONS
  Due to the multiple safety concerns associated with the use of the On-Q infusion systems (I-Flow Corporation, Lake Forest, CA) in a community-based teaching institution, a multidisciplinary team of physicians, pharmacists, clinical nurses, nurse educators, and computer informatics personnel was formed to develop a standardized policy and procedure to ensure the safe use of On-Q pumps. The policy addressed several problems concerning prescribing, dispensing, administration, and monitoring of these pumps. The patient care policy for use of On-Q pumps dictates how the pumps are stocked, ordered, dispensed, administered, and monitored and the drugs approved for use in the pumps. Education bulletins, a summary of the new policy and procedure, and a formal presentation of the policy and procedure to unit-based nurse educators were provided. The focus was on a consistent message of safety by reiterating the problems described with these pumps in the literature and in the health care system itself. The physicians ordering the devices have provided positive feedback regarding the simplified ordering process and standardization of the pumps, medications, and concentrations. Both dispensing pharmacists and bedside nurses have noted that the orders are clearly communicated via the computerized system. The addition of documentation in the computer system and education regarding potential signs and symptoms of adverse events with the medication used with the pumps was greatly appreciated by the nursing staff.
  
  
  CONCLUSIONS
  A health care system instituted measures to enhance the safety of using an elastomeric infusion system for pain management.
authors.affiliation: Department of Pharmacy Services, Orlando Regional Medical Center, USA.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Birrer
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Anderson
authors.forename: Xi
authors.initials: X
authors.lastname: Liu-DeRyke
authors.forename: Kuldip R
authors.initials: KR
authors.lastname: Patel
mesh_terms: D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects; D016503:Drug Delivery Systems / Q000009:adverse effects / Q000379:methods / Q000592:standards; D004335:Drug and Narcotic Control / Q000379:methods*; D020724:Elastomers / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects* / Q000592:standards; D010146:Pain / Q000188:drug therapy* / Q000378:metabolism; D010595:Pharmacists / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000379:methods* / Q000592:standards; D012449:Safety
chemical_list: D020724:Elastomers; D002045:Bupivacaine