Infusion Management and Auto Pump Programming University Of Missouri Marcia Stewart, RN Sr. Clinical Strategist

Agenda Scope of Project Glossary of Terms iAware Infusion Management -introduction Auto Pump Programming- introduction Benefits Timeline – Target February Process Issues Demo Requests Trip to Cerner / Kansas City What I’m not covering: Pharmacy Workflow / Infusion Billing

iAware

iAware Overview – What is iAware? “iAware” refers to a platform, not a solution Term is more synonymous with “Millennium” than “FirstNet, Surginet, Scheduling” Platform allows arrangement of “gadgets” or sets of gadgets (content sets) which may have distinct purposes and distinct sources of data iAware is not part of Millennium Some gadgets do get their data from Millennium database or leverage existing Millennium services Code is not delivered in Millennium releases or packages Distinct set of iAware packages with own naming convention, i.e. “iAware 4.4”

iAware Overview - Content Currently two available content sets: iAware for Critical Care iAware Infusion Management Content sets are licensed separately, so being licensed for one does not mean you are licensed for the other

iAware Overview – Two Modes of Operation Dashboard mode: Always on, displayed on wall as a dashboard Operates under generic user context / user does not log in or log out Intended to provide viewers with patient context while requiring little interaction / scrolling Allows nurse unit filtering No customization of perspectives or gadget layout Personalized mode: Supports the individual workflow and runs on user devices Requires user to log in / out using his/her Millennium credentials Enforces encounter-org security and patient-provider relationships Allows individual users to customize layouts (add/remove/move/resize gadgets and create/customize perspectives)

iAware Overview – Dashboard Mode

iAware Overview – Personalized Mode

Infusion Management

Infusion Management What is Infusion Management Review of Functionality Key Design Decisions Lessons Learned Enhancements

iAware Platform – Cerner Solutions Critical Care Infusion Management EPS Patient, Provider and Equipment Tracking Physiologic Waveforms APACHE Critical Care Mobile Staff Link EPS Capacity Management

Requirements for CareAware Infusion Management iAware Framework and CareAware Infusion Management CareAware iBus Smart Infusion pumps and associated drivers Millennium code base of 2007.19 Interactive View, I&O2G, eMAR, PharmNet

Infusion Management Goals Centralized views to manage infusions Increase nursing and pharmacy efficiencies Removes the nurse as the integrator of devices and data Pro-active volume status and alerting directly from device and MDBus Near real-time Pharmacy awareness of infusion status Evaluate effect of infusions on patients Near real-time graphical display of infusion data directly from device Correlate with near real-time graphical display of physiologic data Comprehensive documentation Document rate, dose rate, and volume in one step Document associated infusion information in context with hemodynamic and vital sign documentation Infusion Management Gadgets available in iAware Framework driven by CareAware and the iBus

Infusion Management Unit View Patient Infusion Status Patient to Device Association Documentation Graphing Pharmacy Infusion Status

Comprehensive View of Infusions

Correlate with Patient Specific Information

Infusion Documentation

Verified and Real Time Physiologic & Infusion Data

Infusion Graph Enhancements UOP decimal precision Display most recently documented result with same date/time Added rSO2 concepts to Hemodynamics graph Collapse zoom

Documentation Enhancements Feasible limit checking during documentation Ability to document a witness for infusion rates when required Selecting an hourly column will select the infused volume results for the previous hour Pharmacy dispense status in hover

Documentation – Hourly Column Selection

Documentation – Second Nurse Witness

Infusion Management Enhancements Dispense status in hover Unit view Patient Infusion Status Infusion Documentation

Lessons Learned Strong client clinical leadership is a must to drive the project Bedside clinician involvement early and often Test based on clinician workflow – not feature/function Drug library for infusion pumps when incorporating IV Auto-Programming – test, test, test Technical resources for iBus and server management

Infusion Management Resources Reference Pages https://wiki.ucern.com/display/reference/CareAware+iAware+Reference+Pages iAware Implementation Group – uCern https://connect.ucern.com/community/cerner/associates/groups/iaware-implementation-group Demonstration Applications https://wiki.ucern.com/display/reference/Access+iAware+Demonstration+Applications

Auto Pump Programming September 11, 2018

What is Auto Pump Programming? Sending Cerner medication charting window to Auto Program the pump

What are the Benefits of Auto Pump Programming Time 40 steps down to 7? 20 steps down to 2? Safety Removes manual entry Much more accurate Guard rails

Prerequisites for Auto Pump Programming iBus Certified Smart Pump Point of Care

Auto Pump Programming Workflow Scan the Patient

Auto Pump Programming Workflow Scan the Medication

Auto Pump Programming Workflow Complete Required Fields

Auto Pump Programming Workflow Click Program

Auto Pump Programming Workflow Scan the Pump

Auto Pump Programming Workflow Programmed – Waiting Confirmation

Auto Pump Programming Workflow Confirm Program – Start Pump Pump does not automatically start… still needs clinician validation

Auto Pump Programming Workflow Real-Time Communication Back from Device Automatic 5 Rights checking Verifies IV pump settings Programs IV pump from order detail The device “knows” who/what is attached Devices are integrated… not interfaced

Questions?