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The Future of Medication Administration. Medication Administration via Depot Technology. Tyler McGrath Nursing 357. Objectives. Describe d epot technology Describe the materials involved Discuss how this technology works Discuss the advantages and disadvantages

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Objectives
Objectives

  • Describe depot technology

  • Describe the materials involved

  • Discuss how this technology works

  • Discuss the advantages and disadvantages

  • Describe the information systems

  • Describe the competencies of depot technology

  • Discuss the legal and ethical issues


Depot technology
Depot Technology

  • Depot is an injection

  • Oil or Polymer

  • Medication mixed

  • Ease of use

  • Subcutaneously(SubQ) or intramuscularly(IM)

intramuscularinjectionsim.blogspot.com

(Corporation, 2008) (Berkowitz, 2009)


Depot technology1
Depot Technology

  • Slow, steady entry into the blood stream

  • Enables high concentrations with smaller amounts

  • Low cost

  • Involves minimal teaching

  • Being studied for pain management

(Corporation, 2008) (Berkowitz, 2009)


Hardware used in a depot injection
Hardware Used in a Depot Injection

This depends on the injection

IM - 20 gauge needle, 1 to 1 ½ inch

SubQ– 25 - 30 gauge needle, ½ to 5/8 inch

Biodegradable polymer

(Berkowitz, 2009)

Unsettlingdown.wordpress.com


How does this polymer technology work
How Does This Polymer Technology Work?

  • The medication in injected into the body

  • A medication infused polymer solidifies

  • Medication is released over days or months

  • The polymers are biodegradable

(Berkowitz, 2009)


Positives and negatives of depot usage
Positives and Negatives of Depot Usage

Advantages

Disadvantages

Discontinuation of medications early

Non-compliance

Limited medications

  • Increased compliances

  • Continuous therapeutic levels of medication

  • Clinics for administration

  • Quality of life

  • Decreased side-effects

(O’ceallaigh, 2001) (David, 2001)


Information systems involved
Information Systems Involved

  • Clinical information system

    • Used for the medication administration

    • Captured in the electronic health record (EHR)

    • Spread through the system

Emeraldinsight.com

(McGonigle, 2014)


Information systems summarized
Information Systems Summarized

  • Clinical information systems

    • Driven by barcoded medication

    • Bar codes scan into the EHR

    • The EHR can communicate with multiple healthcare providers

    • The healthcare providers are able to communicate back


Competencies and skills
Competencies and Skills

How to draw up a medication

How to use the Z-track method

Assessment of an allergic reaction

Via shutterstock.com

aklasiccommotion.wordpress.com


Responsibilities of a nurse informaticist
Responsibilities of a Nurse Informaticist

  • Set-up of information systems

    • Maximum communication

    • Provide a record keeping system

    • Less medication errors

    • Timed administration for medications that last longer


Legal issues and ethics
Legal Issues and Ethics

Removal in patients with a history of mental instability

To remove or not

Birth control

Long term effects on reproduction

“…critics have associated administering medication in this form with coercive or forced treatment.” (O'ceallaigh, 2001)

Via Corevalues.com



Sedasys system

SEDASYS System

Lindsay Keeley


Sedasys system1
SEDASYS System

  • Computerized-assisted personalized sedation device

  • Delivers the drug propofol

  • How does it work?

    • IV infusion

    • Over sedation

(“SEDASYS,” 2014)


Parts of the sedasys
Parts of the SEDASYS

(“Sedation,” 2014)


Administration
Administration

  • Allows non-anesthesia professionals to administer propofol

    • Colonoscopy

    • EGD

  • Initiating propofol sedation

  • Maintaining propofol sedation

(“SEDASYS,” 2014), (“Sedation,” 2014)


Contraindications
Contraindications

(“SEDASYS,” 2014)


Safety precautions
Safety Precautions

  • Lockout Timers and Dosing Limits

    • 3-minute maintenance rate increase lockout timer

    • 90 second PRN dose lockout time

    • To reduce accidental overdose

      • Max initial dose of 75 mcg/kg/min

      • Maintenance rates increases limited by patient responsiveness

(“Sedation,” 2014)


Safety precautions1
Safety Precautions

  • Responsive Oxygen Delivery

    • Oxygen delivered to patient’s nose and mouth

    • amount of oxygen is automatically adjusted

    • Oxygen source must be connected to device

(“Sedation,” 2014)


Safety precautions2
Safety Precautions

(“Sedation,” 2014)


Studies
Studies

  • Lower occurrences of hypoxemia

  • 2.5% of patients were in deeper sedations than intended

  • ISAP is working to prevent and decrease these occurrences

(“SEDASYS,” 2014)


References
References

  • SEDASYS Computer-Assisted Personalized Sedation System - P080009. (2014, August 7). In U.S. Food and Drug Administration. Retrieved October 7, 2014, from http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/recently-approveddevices/ucm353950.htm

  • Sedation Redefined. (2014). In Sedays. Retrieved September 16, 2014, from http://www.sedasys.com/


References1
References

  • David, A., & Adams, C. (2001, January 1). Depot antipsychotic medication in the treatment of patients with schizophrenia: (1) Meta-review; (2) Patient and nurse attitudes. Retrieved September 18, 2014, from http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/ 0011/64658/FullReport-hta5340.pdf

  • Corporation, D. (2008, January 1). SABER™ Depot Injection Technology. Retrieved September 18, 2014, from http://www.durect.com/pdf/saber_brochure_20080107.pdf

  • O'ceallaigh, S., & Fahy, T. (2001, January 1). Psychiatric Bulletin. Retrieved September 18, 2014, from http://pb.rcpsych.org/content/25/12/481.full


References2
References

  • Berkowitz, A., & Goddard, D. (2009). Novel Drug Delivery systems: Future Directions. Journal of NueroscienceNursing, 41(2), 115-120. (2009, April 1).


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