mp:Kickstart Workflow Intravenous Therapy: verschil tussen versies

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Regel 9: Regel 9:
 
=Introduction=  
 
=Introduction=  
  
The information standard Medication Process 9 (MP9) has not yet been fully developed. Further development is needed, among other things, for the exchange of data regarding infusion therapy. That is why separate agreements have been made for the Kickstart based on decision VO37of the core team decisions. This decision does not make it sufficiently clear what infusion data is and is not exchanged. Further elaboration has been made in consultation with administration sectors, medical specialists and a number of software suppliers. This is explained below for different situations.  
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The information standard Medication Process 9 (MP9) has not yet been fully developed. Further development is needed, among other things, for the exchange of data regarding infusion therapy. That is why separate agreements have been made for the Kickstart based on decision VO37 of the core team decisions. This decision does not make it sufficiently clear what infusion data is and is not exchanged. Further elaboration has been made in consultation with administration sectors, medical specialists and a number of software suppliers. This is explained below for different situations.  
  
 
This working method applies to the Kickstart and will be further developed in parallel.
 
This working method applies to the Kickstart and will be further developed in parallel.
Regel 36: Regel 36:
 
This appears as one line on the administration list.
 
This appears as one line on the administration list.
  
===Gereedmaken infuus voor toediening door toediener===  
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===Prepare infusion for administration by operator===  
  
Wanneer de toediener het infuus voor toediening gereed maakt, moet de apotheek het oplosmiddel apart leveren van het geneesmiddelEr worden daarom twee aparte, parallelle TA’s aangemaakt onder één MBH, een voor het oplosmiddel en een voor het geneesmiddel. Dit zal leiden tot twee regels op de toedienlijst: één voor het geneesmiddel en één regel voor het oplosmiddel.
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When the operator prepares the infusion for administration, the pharmacy must supply the solvent separately from the medicineTherefore, two separate, parallel TAs are created under one MBH, one for the solvent and one for the drug. This will result in two lines on the administration list: one for the drug and one for the solvent.
  
=Toedienen=  
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=Administer=  
  
Met name rondom infuustoedieningen zijn aparte afspraken gemaakt die alleen gelden tijdens de Kickstart. Niet alle infuustoedieningen zullen worden uitgewisseld en zijn dan ook niet beschikbaar in de keten voor bijvoorbeeld een overzicht ten behoeve van toedieningen. Daarnaast is niet alle informatie over infuustherapie volledig. Hieronder volgt een toelichting:
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Special agreements have been made regarding infusion administration that only apply during the Kickstart. Not all infusion administrations will be exchanged and are therefore not available in the chain for, for example, an overview of administrations. In addition, not all information about infusion therapy is complete. Below is an explanation:
 
   
 
   
* MTD’s van enkelvoudige producten (infusen met één werkzame stof), die al dan niet voor toediening gereed worden gemaakt, worden uitgewisseld.
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* MTD's of single products (infusions with one active substance), which may or may not be prepared for administration, are exchanged.
  
* Twee werkzame stoffen in één infuuszak kunnen wel in het informatiesysteem als medicatietoediening geregistreerd worden, maar worden niet uitgewisseld. De bijbehorende MA’s en TA’s kunnen al wel voor worden uitgewisseld. Alternatief is dat dit als magistraal wordt uitgewisseld, dan kunnen de MTD’s wèl uitgewisseld worden.  
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* Two active substances in one infusion bag can be registered in the information system as medication administration, but are not exchanged. The associated MAs and TAs can already be exchanged. The alternative is that this is exchanged as a magistral, then the MTDs can be exchanged.
  
* In de MTD kan een Toedieningssnelheid vermeld worden en deze kan worden uitgewisseld. De loopsnelheden die zijn opgenomen in de MA en de TA, worden ook opgenomen in de MTD en kunnen worden uitgewisseld. Wanneer toedieningssnelheden niet zijn opgenomen in de MA of de TA en een toediener brengt zelf een wijziging aan, wordt deze niet in de MTD uitgewisseld. Wisselingen in toedieningssnelheden kunnen niet worden uitgewisseld in de keten.  
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* An Administration Rate can be stated in the MTD and this can be exchanged. The running speeds included in the MA and TA are also included in the MTD and can be exchanged. If application rates are not included in the MA or TA and an operator makes a change themselves, it will not be exchanged in the MTD. Changes in administration rates cannot be exchanged in the chain.  
  
* Wisselingen in loopsnelheid kunnen niet worden uitgewisseld. Bijvoorbeeld, wanneer een kortwerkende insuline toegediend wordt waarbij wisselingen in loopsnelheden van toepassing zijn. In sommige toedienregistratiesystemen kunnen pompstanden wel geregistreerd worden. Uitwisseling hiervan is in de Kickstart niet mogelijk.   
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* Variations in infusion rate cannot be exchanged. For example, when a short-acting insulin is administered where variations in walking speeds apply. Pump levels can be registered in some administration registration systems. Exchange of these is not possible in the Kickstart.   
  
* Wanneer er een nieuwe spuit of infuuszak wordt aangehangen bij de patiënt en geregistreerd, zal altijd het totale volume worden uitgewisseld in de MTD. Wanneer uiteindelijk blijkt dat maar de helft van het totaal volume is ingelopen, kan dit geregistreerd worden door de medicatietoediening te corrigeren. Dit betekent dat het restvolume van de infuuszak wordt geregistreerd in een nieuwe MTD. Het betreffende restvolume wordt geregistreerd als een negatief getal, bijvoorbeeld -200ml. Hiermee kan de totale toediening berekend worden. Het originele volume van bijvoorbeeld 1 l, min het restvolume van 200 ml, resulteert in een totale toediening van 800ml. Zie hiervoor use case x  
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* When a new syringe or infusion bag is attached to the patient and registered, the total volume will always be exchanged in the MTD. If it ultimately turns out that only half of the total volume has been administered, this can be registered by correcting the medication administration. This means that the residual volume of the infusion bag is registered in a new MTD. The relevant residual volume is recorded as a negative number, for example -200ml. This allows the total administration to be calculated. For example, the original volume of 1 l, minus the residual volume of 200 ml, results in a total administration of 800ml. See use case x for this
  
* In een opname- of ontslagsituatie kan een schriftelijke overdracht nodig zijn van MTD’s  of andere infuusgegevens die niet uitgewisseld kunnen worden. Hierbij kunnen relevante MTD’s van de afgelopen 24 uur meegegeven worden. Ook kan hierbij het volume van een infuus dat meegaat, worden overgedragen.
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* In an admission or discharge situation, a written transfer of MTDs or other infusion data that cannot be exchanged may be necessary. Relevant MTDs from the past 24 hours can be included. The volume of an infusion that will last can also be transferred.

Versie van 4 jun 2024 om 16:56


1 Introduction

The information standard Medication Process 9 (MP9) has not yet been fully developed. Further development is needed, among other things, for the exchange of data regarding infusion therapy. That is why separate agreements have been made for the Kickstart based on decision VO37 of the core team decisions. This decision does not make it sufficiently clear what infusion data is and is not exchanged. Further elaboration has been made in consultation with administration sectors, medical specialists and a number of software suppliers. This is explained below for different situations.

This working method applies to the Kickstart and will be further developed in parallel.

2 Prescribe

The following agreement applies to prescribing infusion therapy in the Kickstart:

The active substance is included in the MA. A reference to a schedule or protocol for preparing the infusion or solvent can be included in the data element 'Explanation'. The same applies to (short-acting) insulins.

If several active substances are prescribed, this usually results in the same number of MAs or a magistral.

3 Dispense

3.1 Clinical situation

In the clinical situation, the solvent is almost never prescribed separately. One TA with the active substance will suffice.

3.2 Ambulatory situation

In the home situation, both the pharmacy and the administrator can prepare the medicine for administration.

3.2.1 Prepare infusion for administration by pharmacist

The pharmacist creates a TA with a magisterial in which both the medicine and the solvent used are registered as ingredients.

This appears as one line on the administration list.

3.2.2 Prepare infusion for administration by operator

When the operator prepares the infusion for administration, the pharmacy must supply the solvent separately from the medicine. Therefore, two separate, parallel TAs are created under one MBH, one for the solvent and one for the drug. This will result in two lines on the administration list: one for the drug and one for the solvent.

4 Administer

Special agreements have been made regarding infusion administration that only apply during the Kickstart. Not all infusion administrations will be exchanged and are therefore not available in the chain for, for example, an overview of administrations. In addition, not all information about infusion therapy is complete. Below is an explanation:

  • MTD's of single products (infusions with one active substance), which may or may not be prepared for administration, are exchanged.
  • Two active substances in one infusion bag can be registered in the information system as medication administration, but are not exchanged. The associated MAs and TAs can already be exchanged. The alternative is that this is exchanged as a magistral, then the MTDs can be exchanged.
  • An Administration Rate can be stated in the MTD and this can be exchanged. The running speeds included in the MA and TA are also included in the MTD and can be exchanged. If application rates are not included in the MA or TA and an operator makes a change themselves, it will not be exchanged in the MTD. Changes in administration rates cannot be exchanged in the chain.
  • Variations in infusion rate cannot be exchanged. For example, when a short-acting insulin is administered where variations in walking speeds apply. Pump levels can be registered in some administration registration systems. Exchange of these is not possible in the Kickstart.
  • When a new syringe or infusion bag is attached to the patient and registered, the total volume will always be exchanged in the MTD. If it ultimately turns out that only half of the total volume has been administered, this can be registered by correcting the medication administration. This means that the residual volume of the infusion bag is registered in a new MTD. The relevant residual volume is recorded as a negative number, for example -200ml. This allows the total administration to be calculated. For example, the original volume of 1 l, minus the residual volume of 200 ml, results in a total administration of 800ml. See use case x for this
  • In an admission or discharge situation, a written transfer of MTDs or other infusion data that cannot be exchanged may be necessary. Relevant MTDs from the past 24 hours can be included. The volume of an infusion that will last can also be transferred.