ROBYN JACKSON

More than 1.5 million preventable medication injuries occur annually, according to the Institute of Medicine, while preventable medical errors kill as many as 98,000 Americans every year, but some Mississippi hospitals are taking high-tech steps to ensure patient safety when administering medication.

Central Mississippi Medical Center in Jackson, Southwest Mississippi Regional Medical Center (SMRMC) in McComb and Crossgates River Oaks Hospital in Brandon are three of the first hospitals in the nation to begin using the SafeScan System in an effort to safeguard patients from medication errors. The system was developed by IntelliDOT, which was founded in 2002 and is located in San Diego.

"It is not a time saver, but has definitely increased patient safety by having a double check of the five rights (right medication, right time, right route, right patient, right dose)," said Ramie Polk, RN, Patient Safety coordinator and SafeScan administrator at CMMC, which has used SafeScan for a year.

The handheld interactive devices, which are called CAREts, link wirelessly to the hospital's pharmacy to ensure and document that patients are given the right medications and doses. Information is updated constantly and all medications are bar coded and individually packaged.

Nurses log on to the CAREts by scanning their badges and entering a PIN code. When it is time to administer medication, the nurse scans the bar code on the patient's wristband. The medications are then scanned and the handheld device displays important information to assure safety and accurate administration. For patients who are receiving injections, the device can even require the nurse to enter the injection site while it displays the last site used. If a physician calls for an injection immediately, SafeScan checks for allergy and drug interactions through a link with specially designed software.

After all the medications are given to the patient, the nurse scans her badge again to complete the transaction.

SafeScan can stop the administration of medication if discrepancies occur.

"In just the last decade, the number of drugs available has grown more than 500 percent and the patients we see are becoming increasingly more complex, medically," said Webb Willmott, pharmacy director of Central Mississippi Medical Center. "We have had to become more sophisticated in our efforts to reduce or eliminate medication errors. By implementing the SafeScan System in our hospital, we have underscored our ongoing commitment to the well-being of the community."

Crossgates River Oaks Hospital announced in June that it had invested in the SafeScan System. "We are very excited about the sophistication of this new system," said Allen Tyra, CEO, in a press release. "This is just another way that we are meeting the healthcare needs of our community."

SMRMC began looking at barcode point-of-care (BPOC) medication delivery systems as early as 2000, but an evaluation committee, made up of nursing, pharmacy and IT staff, rejected each one because they were too difficult to use and they knew the nurses wouldn't use them. In 2005, the committee reviewed several vendors with the latest generation of BPOC products, and they felt that the IntelliDOT system best fit their needs.

After a pre-implementation study in early 2006, and a pilot trial that summer, SMRMC implemented the SafeScan System in fall 2006, starting with the hospital's pharmacy. IntelliDOT trained 12 nurse "super users" who were available along with the IntelliDOT technical team to assist the rest of the staff on the day the system went live. Each staff member was given four hours of training.

"When we first discovered the IntelliDOT CAREt System, we had some doubts because it seemed too simple to be true, but after evaluating it further, we really liked it," said Katie McKinley, assistant administrator, Nursing Services, at SMRMC, in a press release. "Many of the other systems we looked at required making changes to the workflow process. Also, other systems had issues with the software that would allow staff to bypass certain procedures or create 'workarounds' that could compromise patient safety. That isn't possible with IntelliDOT."

The system first rolled out to the post-op surgical unit at SMRMC, then spread hospital-wide with the exception of the surgical suites and the ER.

The devices fit into scrub or lab coat pockets and can be operated with one hand.

"The CAREt System isn't cumbersome like the computer on wheels system, which is heavy to push and too big to take into our small hospital rooms," McKinley said. "Leaving the cart in the hall violates fire safety codes for hospitals, so the CAREt System helped us eliminate that problem."

The 160-bed SMRMC, which serves seven rural Mississippi counties and two Louisiana parishes, has a use compliance rate of 96-97 percent, she said.

Change is often difficult to implement, but the nurses at Jackson's CMMC have accepted the new system.

"It was a little difficult at first, but nurses are trained to be patient advocates and if it means increased safety for the patient, it isn't too hard to try something new," Polk said.

Patients have adjusted to the new system, too, Polk said.

"Because new technology is always being introduced into the healthcare area, I think patients come to expect the newest technology wherever they go. Some patients do ask about the system and seem pleased to know it is in place to increase their safety."

Most importantly, McKinley said the system has prevented some mistakes. Since implementation, the hospital has reduced total errors from 68 to 3. There have been a few times when a nurse went into a room to administer medication and the handheld device indicated "no orders found" when the patient's wristband and the medications were scanned. They tried again and got the same message. That's when the nurse realized she was in the wrong room.

"These incidents have awakened us to the fact that we are humans and that we've probably made mistakes in the past that we've never known about," McKinley said.