Patient Safety: Safe Medication Delivery with Closed-Loop Medication Management

In 2015, a nursing home caregiver in Minnesota who was under a lot of work pressure mistakenly recorded a medication order for the wrong patient. As a result, a resident who was supposed to receive warfarin didn’t get the correct dosage for nine days, leading to a stroke and the resident’s death. Likewise, in 2016, a pharmacy dispensed the antipsychotic drug Navane (thiothixene) instead of the blood pressure medication Norvasc (amlodipine) to a 71-year-old patient, causing severe physical and psychological harm to the patient.

These cases are part of the roughly 7,000 to 9,000 annual deaths and 1.5 million injuries in the United States attributed to medication errors. A significant number of these mistakes occur because of problems with communicating dosages and drug orders, as well as confusion between drugs with similar names.

Medication workstations can be crucial in addressing these problems by enabling administrators and directors to equip their staff with the latest technology. One practical approach is closed-loop medication management, which has demonstrated tangible benefits, including an overall reduction in adverse drug events, a 10% decrease in harmful errors, and saving an hour in staff medpass work time.

What is Closed-Loop Medication Management?

Closed-loop medication management systems use modern technology to prevent medication dosing errors by replacing each manual step with a computerized one. In a closed-loop system, the doctor or caregiver enters the order directly into a computer, keyed to the patient’s wristband or other barcode. This computerized order goes directly to the pharmacy. The medication is typically stored in an automated dispensing cabinet, such as a NexsysADC. It is then retrieved and placed into the MedLink system for delivery to the patient.

The MedLink logs the medication retrieval and dosage, seamlessly updating the patient’s records within the hospital or facility’s computer system.

The closed-loop system ensures that even if the drawer is mislabeled and taken to the patient’s room, it cannot be opened. Medication can only be delivered to the patient for whom the drawer is programmed. This helps prevent giving incorrect doses to patients and other potentially dangerous errors.

MedLink Medication Management Workstations

Mobile workstations are essential tools in modern hospitals and clinics. These powered or manual carts efficiently move supplies and equipment between rooms, eliminating the need for staff to return to supply closets repeatedly. Specialized workstations, such as Capsa’s MedLink Medication Management Workstation, offer focused support by facilitating medication delivery.

The MedLink Medication Management Workstation is a specialized portable medication delivery system designed to streamline the process. It transports medications directly from the pharmacy to the patient’s bedside without unnecessary detours. This closed-loop system minimizes errors and enhances patient safety. With no reliance on additional staff inputs or side trips for signatures, the likelihood of errors is significantly reduced. This single-trip approach also eases the workload for staff and reduces paperwork. Nurses and clinicians no longer need to make multiple trips to the pharmacy, as the workstation can accommodate all the necessary supplies and medications.

Electronic Medical Records

The caregiver should ask the ” seven rights ” questions before administering any medication. With the EMR accessible at the bedside, these questions are readily available.

• Is this the right patient?
• Is this the right drug?
• Is it the right dose?
• Is it the right time for this medication?
• Is this the right route of administration (oral, IV, epidural)?
• Has the right documentation been completed?
• Is this drug being given for the right reason?

Since the MedLink Medication workstation has features that prevent the drawer from opening unless the correct code is entered, the first four questions have already been answered. The EMR answers the sixth question. Caregivers only need to ensure that the route of administration and the reason for the medication are correct.

Benefits of the MedLink Medication Management Cart

Mobile workstations are great additions to large and small hospitals and clinics. They are versatile and customizable to a range of needs. The MedLink Medication cart offers some unique benefits to administrators and staff alike.

• Safe and accurate medication administration: Each patient is assigned a drawer in the cart, and each drawer can only be unlocked with the patient’s barcode. Once the drawer is assigned, medications are stored and refilled as needed. Drawers will close and lock if left open too long, so medication cannot be removed if a caregiver is called away. The system records each time the drawer is opened and closed for tracking purposes.
• Customizable and adaptable design: The standard cart can support a computer monitor and keyboard, plus two cassette housings. The cart can be configured with one standard cabinet or two high-capacity cabinets that hold twelve different arrangements of drawers. Drawers come in sizes from small to extra-large for all kinds of items, from syringes to bulky supplies.
• Multiple labeling systems: Drawers can be labeled with patient names, room numbers, or supply codes. They can be assigned via a pre-loaded patient list or manually through the keyboard and patient wristband or barcode.
• Streamlined workflows: The AutoScan and MedLink Pro software allows staff to assign the same cart to multiple users throughout the day. Since each drawer is keyed to one patient, there is no risk of cross-delivery of medication. This improves staff workflow while ensuring patient safety.

MedLink Carts Boost Workplace Efficiency

Like all Capsa mobile workstations, the MedLink Medication Management carts are designed with a focus on ease of use and staff comfort. The AutoFit ™ technology allows each user to adjust the height and angle of the work surface and display with a single touch. The powered cart features a one-handed steering function that helps reduce physical stress.

Even in large hospitals, space is always at a premium. All Capsa carts are built with tight spaces in mind. Small footprints allow for easy cart storage and prevent hallway clutter. With Power Track™ steering, caregivers can effectively navigate tight spaces, corridors and turns with one-hand operation for care on the go.

All Capsa workstations are built for easy cleaning to meet infection control standards. The surfaces and drawers are easy to clean and stand up to repeated sterilization and disinfection.

Is MedLink Right for You?

If your facility does not need the complete MedLink Pro software, consider MedLink Lite. Some facilities may not require all system features but need the safety and security of the closed-loop medical management system.

• Long-term patient care environments, such as nursing homes and assisted living facilities, may not require the capacity and flexibility a high-turnover acute care facility requires. 
• Smaller facilities won’t need to assign a single cart to multiple users per shift. If a single user will handle the medication delivery for each shift, the MedLink Lite system may be sufficient. 
• If the cart is 100% self-contained, it can provide records of cart usage, medication access, and other auditing information. If your system is already set up to capture this information elsewhere, you will not need the additional software immediately.

Other advantages to acquiring the complete MedLink Pro software include tracking and AutoScan. Consider the specific needs of your facility before making your final determination.

Bringing the MedLink Medication Workstation to Your Facility

The MedLink Medication Management Workstation can enhance medication administration in healthcare settings. It ensures patients receive the proper medications, reduces the physical strain on caregivers by minimizing trips to supply rooms and pharmacies, and enhances the accuracy of medication prescribing, distribution, and delivery. Healthcare administrators can also reduce liability by upgrading their technology.

If you believe the MedLink Medication Management Workstation could benefit your organization, please contact our consultants for a review of your specific needs. You can reach us at 1-800-437-6633 or submit an online request form. We will get in touch to discuss suitable mobile workstation options and how our closed-loop system can improve your workplace.