The future of medication administration
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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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The Future of Medication Administration

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The future of medication administration

The Future of Medication Administration


Medication administration via depot technology

Medication Administration via Depot Technology

Tyler McGrath

Nursing 357


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


Summary of the depot

Summary of the Depot


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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