Medication errors have long been a leading cause of death around the world. In the United States alone, the U.S. Food and Drug Administration (FDA) receives over 100,000 reports each year documenting various types of medication mistakes. Though strides are continually being made to mitigate this problem, medication mismanagement continues to plague healthcare systems everywhere. Among the many types of medication administration errors are improper dosing, administering a drug at the wrong time, extra dosing or omitting a dose, giving a drug to the wrong patient, and many more. This HealthySimulation.com article shares how healthcare simulation medication administration can be used to reduce medical errors.
Since the Pocket Nurse’s inception in 1992, one of the primary missions of the company and founder, Registered Nurse Anthony Battaglia, has been to reduce medication errors through medical simulation-based education. Battaglia has long believed this effort begins with high-quality instruction combining three key components.
The first element is the ultra-realistic simulations that promote critical thinking under pressure. The second element is the use of industry-current automated dispensing systems in those scenarios. Simulated medications, such as those in the Demo Dose collection, that look nearly as authentic as their clinical counterparts are the third component.
Pocket Nurse distributes a range of automated dispensing cabinets that are integral to creating convincing medication administration scenarios. Three examples of proven systems are highlighted below, each performing similar functions by somewhat different methods:
1. Med Dispense System with Demo Dose:
2. SimCartRX and SimCabRX Systems with Demo Dose: Developed specifically for use in simulation-based education, these units provide students with the familiarity of medication dispensing combined with the flexibility of customizable education-based features. Pocket Nurse is the exclusive partner with KBPort to distribute various Demo Dose SimCartRX and SimCabRX devices, based on individual customer needs.
3. Omnicell Medication Dispensing Cabinets: These cabinets enable practice using the exact systems that many students will see in clinical and after graduation. Pocket Nurse is the sole provider of Omnicell for healthcare education. The Omnicell XT Series is a highly configurable medication dispensing solution that maximizes workflow efficiency without sacrificing patient safety. This system can be expanded with additional cabinets and drawers to meet a wide range of instructional needs and is available in three sizes that maximize storage for medications and bulk PPE supplies.
The profile-driven dispensing solution mirrors hospital nursing workflow, allowing for the most realistic learning experience. Omnicell’s Guiding Light Technology and Touch & Go Biometric ID streamlines workflow efficiencies with increased security. Paired with the included Demo Dose software, Omnicell’s barcode scanner is ready to quickly identify Demo Dose-brand simulated medications.
Equally important as dispensing systems for creating meaningful medical simulations, Demo Dose simulated medications offer a safe yet realistic approach for practicing medication administration. Until 2004, healthcare education programs were mostly self-reliant for their simulated medication. The expired medication would often be used, which was a realistic yet risky practice. Instructors would also rely on various candies to serve as pills and create their own labels which were often costly and time-consuming. There was clearly a need in medical education for a better teaching tool.
Pocket Nurse launched Demo Dose in 2004, as a simulated medication solution that was tailor-made for education to help learners practice the “Five Rights” of medication administration: right patient, right drug, right dose, right route, and at the right time. Designed specifically for healthcare simulation safety while featuring a realistic appearance, these simulated drugs contain only inert ingredients with no Active Pharmaceutical Ingredients (APIs).
Drug names on labels are purposely misspelled, omitting the last vowel for easy recognition, such as “Insuln” in place of “Insulin.” “Greeking” on simulated IV fluids is utilized in place of normal directions to indicate its non-medical status. In addition to other safety measures, all Demo Dose products carry a strong disclaimer boldly printed on every label to ensure their proper use: “For Instructional Use Only. Not for Human or Animal Use.”
The diverse Demo Dose product portfolio currently offers over 400 simulated medications, with more continually being added – often upon instructor request. Demo Dose products include:
- Ampules are ideal for practicing medication draws, ampule breaking and handling, and practicing overdose management with simulated Narcan (Narcn).
- Vials are excellent for teaching drug reconstitution, proper medication draws, treatment of diabetes, malignant hyperthermia scenarios, and much more. Vials are also included as part of many Totes simulation supply bags and product bundles.
- Prefilled syringes are labeled to look like popular injection types and are well suited to teaching subcutaneous injections, flushes, and proper use in code scenarios. These are also included in the First-In EMS simulation bag, a range of Totes simulation supply bags, crash cart drawer refills, and more.
- Patches are frequently used to teach central line care and management, plus transdermal medication administration including simulated fentanyl (fentnyl) and vasodilators such as simulated nitroglycerin (nitroglycern).
- Oral medications such as capsules (gel or powder), tablets (scored or not scored), and liquid suspensions are ideal for Pharmacy programs, teaching oral medication administration, pill cutting/crushing techniques, and much more.
- Inhalers, both disc, and aerosol types are central to teaching medication administration via metered dose inhalers (MDIs), and a wide range of respiratory treatments.
- IV solution bags include premixes, simulated blood products, total parenteral nutrition (TPN), and a range of patient IV treatment types.
- Inject-Ed injection trainers are ideal for practicing different injection techniques and are available in two sizes.
Demo Dose products have been widely embraced by many leading healthcare education programs in the United States. Duquesne University in Pittsburgh and its nationally ranked School of Nursing is one of those programs and was among the first to use Demo Dose for its simulations.
Rosanna Henry, MSN, RN, CHSE is the Assistant Dean for Clinical Skills and Simulation Education at Duquesne University. For 23 years, Professor Henry has helmed Duquesne’s renowned undergraduate Nursing program, its 700 students, and 150 instructors. Early in her tenure, she realized a compelling need for more realistic simulated medications.
Like many Nursing programs at the time, Duquesne’s simulations utilized candy, expired medication (with a prominent “not for human use” label), and other house-made solutions to replicate real medications. When Demo Dose was introduced in 2004, Duquesne Nursing was quick to adopt the realistic new solution. “From the moment Demo Dose came out, we’ve been a customer,” she stated. Duquesne nursing learners begin using Demo Dose products as sophomores in the simulation lab, in the Fundamentals of Nursing course.
In that class, learners get their first hands-on exposure to realistic medical simulations and simulated medications. For Professor Henry, the realism that Demo Dose brings is vital to both learning and instruction: “Realism in simulation is key – if you don’t have buy-in from the learner, they’re not going to learn. If it’s real, and it matches what they’re seeing clinically, it helps the student and helps us to teach better. I can’t imagine teaching without it.”
Professor Henry says the most profound impact of Demo Dose can be seen in newer learners and in critical case scenarios where it serves as a powerful teaching tool. She states, “We use Demo Dose code drugs for mock cardiac arrests and those are so helpful and realistic – and exactly like they will see on clinical.”
Professor Henry says that they use “just about everything in the catalog,” from simple Inject-Ed injection trainers (each student is issued one) to Totes simulation supply bags, to various equipment and supplies in the healthcare simulation lab that Pocket Nurse helped to first outfit years ago. “I can’t imagine not having Demo Dose now,” she added.
To learn more about Medication Management Solutions and Demo Dose simulated medication, join Pocket Nurse Senior Account Manager Kurtis Kabel and Nurse Educators Beth Telesz, MSN, RN, and Fabien Pampaloni, MSN, RN, for a FREE webinar, on October 12 at Noon EST at HealthySimulation.com.
More About Pocket Nurse
Pocket Nurse is a US-based company that makes and distributes medical supplies and equipment for healthcare simulation and education in medicine, nursing, EMS, pharmacy, and other allied health groups. The company’s products are extensively used in nursing simulation but have applications across the entire range of the medical simulation industry.
Pocket Nurse began business in 1992 with one product, the Pocket Organizer. This organizer was so popular, that the solution led the way to the production and sale of over 5600 products which now include manikins from Laerdal, moulage tools, and headwalls. The company was founded and owned by a nurse, Anthony Battaglia — who still oversees the company to this day.
One of Pocket Nurse’s most popular product lines is their Demo Dose medications. The company has been consistently willing to create new practice medications and packaging to match changing clinical practices. Medical simulation should mimic real-life situations as much as possible as this adds fidelity to simulation scenarios. Having medications and packages that closely resemble actual medications used in practice provides familiarity for learners which in turn, helps them transition from the classroom to clinical practice.