Pharmacy Service, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46, 28007, Madrid, Spain.
Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, C/ Maiquez, 9, 28007 Madrid, Spain.
Int J Med Inform. 2014 Feb;83(2):99-105. doi: 10.1016/j.ijmedinf.2013.10.011. Epub 2013 Nov 13.
To analyze the cost effectiveness of implementing smart infusion pump technology in a pediatric intensive care unit (PICU).
An observational, prospective, intervention study with analytical components was carried out. A drug library was developed and integrated into the Carefusion Alaris Guardrails® infusion systems. A systematic analysis of all the data stored on the devices during use was performed by the data processing program Guardrails® CQI v4.1 Event Reporter. Intercepted errors were classified in terms of their potential severity and probability of causing an adverse effect (PAE) had they reached the patient. Knowing the estimated cost of a preventable adverse effect (AE), we analyzed costs saved and the profit/cost ratio resulting from the implementation process.
Compliance with the drug library was 92% and during the study period 92 infusion-related programming errors were intercepted, leading to a saving of 172,279 euros by preventing AEs. This means that 2.15 euros would be obtained for each euro invested in hiring a pharmacist to implement this technology.
The high percentage of use of safety software in our study compared to others allowed for the interception of 92 errors. The estimation of the potential impact of these errors is based on clinical judgment. The cost saved might be underestimated because the cost of an AE is usually higher in pediatrics, indirect and intangible costs were not considered and pharmacists involved do not spend the whole day on this task.
Smart pumps have shown to be profitable in a PICU because they have the ability to intercept potentially serious medication errors and reduce costs associated with such errors.
分析在儿科重症监护病房（PICU）实施智能输液泵技术的成本效益。
进行了一项观察性、前瞻性、干预性研究，并具有分析成分。开发了一个药物库，并将其集成到 Carefusion Alaris Guardrails®输液系统中。通过数据处理程序 Guardrails®CQI v4.1 Event Reporter 对设备在使用过程中存储的所有数据进行了系统分析。根据潜在严重程度和对患者产生不良影响（AE）的可能性对截获的错误进行分类。了解可预防 AE 的估计成本后，我们分析了实施过程中节省的成本和利润/成本比。
药物库的合规性为 92%，在研究期间截获了 92 个与输液相关的编程错误，通过预防 AE 节省了 172,279 欧元。这意味着每投资 1 欧元聘请药剂师实施这项技术，就可以获得 2.15 欧元的回报。
与其他研究相比，我们研究中使用安全软件的高比例允许截获 92 个错误。这些错误的潜在影响的估计是基于临床判断。节省的成本可能被低估，因为儿科的 AE 成本通常更高，间接和无形成本未被考虑，并且参与的药剂师不会整天都在处理这项任务。
智能输液泵已被证明在 PICU 中是有利可图的，因为它们能够截获潜在的严重药物错误并降低与这些错误相关的成本。
