Other Titles

Controlled Substance Handoff [Poster Title]

Abstract

Purpose: Ensuring the safe handoff of controlled substances during patient transfers is critical in pediatric emergency care. Recognizing gaps in documentation and chain-of-custody processes, this nurse-led initiative aimed to design an innovative, technology-driven approach to enhance patient safety and ensure compliance with regulatory standards. The project focused on integrating advanced tools to streamline workflows, minimize errors, and safeguard pediatric patients.

Methods: A multidisciplinary team, led by pediatric emergency nurses, collaborated to develop a documentation framework leveraging existing health technology. The team adapted the Epic Rover mobile application and electronic medical record (EMR) systems to enable real-time documentation of controlled substances during transitions of care. Trial runs were conducted to assess feasibility, focusing on workflow integration, double-check processes for controlled substances, and capturing infusion details such as rates and remaining volumes. Nurses served as key drivers of workflow design, ensuring the solution aligned with clinical needs while adhering to safety protocols.

Implementation: The solution included a customized Medication Administration Record (MAR) action within the EMR, allowing seamless documentation of controlled substance handoffs, including infusion rates, remaining volumes, and verification by receiving care team members. A training program was developed to ensure nursing staff proficiency in the new workflow, emphasizing the role of double-checks for controlled substances. Multidisciplinary collaboration across nursing, pharmacy, and informatics teams ensured that the implementation met both clinical and regulatory standards.

Implications: This initiative demonstrates the critical role of nursing leadership in identifying gaps, designing innovative solutions, and driving technology integration in clinical practice. By ensuring accurate documentation and compliance for controlled substance handoffs, this project highlights the potential for scalable and generalizable solutions to enhance patient safety in pediatric emergency care settings. It underscores the importance of interdisciplinary collaboration in addressing complex clinical challenges and optimizing workflows through technology. Lessons learned from this initiative may inform broader efforts to enhance the safety of controlled substance handoffs across diverse healthcare settings.

Notes

References:

Benjamin, L., Frush, K., Shaw, K., Shook, J. E., & Snow, S. K. (2018). Pediatric Medication Safety in the Emergency Department. Annals of Emergency Medicine, 71(3), e17-e24. https://doi.org/10.1016/j.annemergmed.2017.12.013

Joseph, M. M., Mahajan, P., Snow, S. K., Ku, B. C., & Saidinejad, M. (2022). Optimizing Pediatric Patient Safety in the Emergency Care Setting. Pediatrics, 150(5). https://doi.org/10.1542/peds.2022-059673

Marufu, T. R., Bower, R. R., Hendron, E., & Manning, J. R. (2022). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 62, e139-e147. https://doi.org/10.1016/j.pedn.2021.08.024

Motulsky, A., Wong, J., Cordeau, J. P., Pomalaza, J., Barkun, J., & Tamblyn, R. (2017). Using mobile devices for inpatient rounding and handoffs: an innovative application developed and rapidly adopted by clinicians in a pediatric hospital. Journal of the American Medical Informatics Association, 24(e1), e69-e78. https://doi.org/10.1093/jamia/ocw107

Samuels-Kalow, M. E., Tassone, R., Manning, W., Cash, R., Davila-Parrilla, L., Hayes, B. D., Porter, S., & Camargo, C. A., Jr. (2024). Analysis of a Medication Safety Intervention in the Pediatric Emergency Department. JAMA Netw Open, 7(1), e2351629. https://doi.org/10.1001/jamanetworkopen.2023.51629

Description

This nurse-led initiative leveraged advanced health technology to improve documentation and safety during controlled substance handoffs in pediatric emergency care. By integrating real-time workflows and emphasizing interdisciplinary collaboration, the project highlights nursing leadership's critical role in advancing patient safety and optimizing clinical workflows. This approach offers scalable solutions for improving controlled substance handoffs across diverse healthcare settings.

Author Details

Lindsey Catterson, BSN, RN, CCRN; Jessica Revet, MSN, RN, CEN; Zainab (Zaina) Alzawad, PhD, M.Ed, MANP, BSN

Sigma Membership

Alpha Alpha Lambda at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Interprofessional and Interdisciplinary, Acute Care, Interprofessional Initiatives, Clinical Practice, Technology in Practice, Handoff, Pediatric Emergency Patients

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-12-06

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Enhancing Pediatric Emergency Medication Safety with Nurse-Led Innovation and Technology

Indianapolis, Indiana, USA

Purpose: Ensuring the safe handoff of controlled substances during patient transfers is critical in pediatric emergency care. Recognizing gaps in documentation and chain-of-custody processes, this nurse-led initiative aimed to design an innovative, technology-driven approach to enhance patient safety and ensure compliance with regulatory standards. The project focused on integrating advanced tools to streamline workflows, minimize errors, and safeguard pediatric patients.

Methods: A multidisciplinary team, led by pediatric emergency nurses, collaborated to develop a documentation framework leveraging existing health technology. The team adapted the Epic Rover mobile application and electronic medical record (EMR) systems to enable real-time documentation of controlled substances during transitions of care. Trial runs were conducted to assess feasibility, focusing on workflow integration, double-check processes for controlled substances, and capturing infusion details such as rates and remaining volumes. Nurses served as key drivers of workflow design, ensuring the solution aligned with clinical needs while adhering to safety protocols.

Implementation: The solution included a customized Medication Administration Record (MAR) action within the EMR, allowing seamless documentation of controlled substance handoffs, including infusion rates, remaining volumes, and verification by receiving care team members. A training program was developed to ensure nursing staff proficiency in the new workflow, emphasizing the role of double-checks for controlled substances. Multidisciplinary collaboration across nursing, pharmacy, and informatics teams ensured that the implementation met both clinical and regulatory standards.

Implications: This initiative demonstrates the critical role of nursing leadership in identifying gaps, designing innovative solutions, and driving technology integration in clinical practice. By ensuring accurate documentation and compliance for controlled substance handoffs, this project highlights the potential for scalable and generalizable solutions to enhance patient safety in pediatric emergency care settings. It underscores the importance of interdisciplinary collaboration in addressing complex clinical challenges and optimizing workflows through technology. Lessons learned from this initiative may inform broader efforts to enhance the safety of controlled substance handoffs across diverse healthcare settings.