Another step toward computerized order entry.
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Computers↗
Biomedical subjects
G Gilroy
Publications and source records attributed to G Gilroy.
Reducing cocaine solution use by promoting the use of a lidocaine-phenylephrine solution.
A program to reduce the use of cocaine solution in a university teaching hospital by promoting the use of a lidocaine-phenylephrine solution is described. To reduce the use of cocaine solution, pharmacists promoted the use of a mixture of lidocaine 3% and phenylephrine 0.25% in place of cocaine solution for nasotracheal intubation procedures. Because initial clinical use of the lidocaine-phenylephrine solution by the anesthesia service was successful, the pharmacy department began in December 1986 to actively promote use of the solution to the bronchoscopy service, the emergency service, and select inpatient nursing units. Educational measures included an article in the pharmacy and therapeutics newsletter detailing the safety and efficacy of the solution, pharmacist description of the program to physicians and nurses, and designation of the solution as a free floor stock item on nursing units. By 1988, total cocaine solution use had decreased by 66% from the 1984 average of 145.7 doses per month to an average of 50.0 doses per month; overall use of topical anesthetics remained constant. The nursing staff supported the use of the lidocaine-phenylephrine solution because it eliminated the extensive record keeping necessary for the cocaine solution. The program to decrease the amount of cocaine solution used was successful and will be expanded to other areas of the hospital.
Anesthesia↗
Integration of pharmacy into the computerized problem-oriented medical information system (PROMIS)--a demonstration project.
The integration of pharmacy into the computerized problem-oriented medical information system (PROMIS) at the Medical Center Hospital of Vermont is discussed. Practioners who generate and retrieve information communicate directly with the computer without intermediary personnel. Touch-screen cathode-ray tube terminals are used for data input. Under PROMIS, the pharmacist has two new resources which better integrate his services into total patient care: (1) the ability to directly access online patient data in the pharmacy, and (2) the ability to directly couple online current drug information to a specific patient's computerized medical record in the pharmacy. The PROMIS solutions to pharmacy problems in drug ordering, drug distribution and drug therapy audit are discussed; In a demonstration project on a 20-bed unit, PROMIS made the medical record readily available to all health care providers, reduced reliance on memory, preserved the logic of medical action, and provided feedback loops for corrective action in everyday medical practice. Also discussed are user acceptance of the system, effect on pharmacy staffing, and implications for pharmacy.
Computers↗