“Hospitals need process improvement tools and methods to break out of their state of low reliability” —The Joint Commission, 20131

eBroselow technology provides an avenue for acute medication administration “to break out of a state of low reliability.” Thanks to eBroselow, accessible, accurate dosing and administration knowledge can be the standard for any patient in emergency and acute situations on the ground or in the air.

Despite the best intentions, evidence shows that hospital patients are routinely2 exposed to the risk of unseen medication errors due to outdated clinical tools in acute care environments.

These errors can delay recovery, extend patient stays, and may, in some instances, be fatal. Despite strides made through education, strict processes, and electronic records, medication errors persist. These errors have been measured in direct observation studies3, and are evidenced in narrative by health care personnel who have lost sleep wondering if they harmed someone today.Its suite of medication safety products has been proven to prevent medication administration errors. eBroselow products are effective in every setting, from community to Children’s hospitals, to doctors’ offices and medical transport. Thanks to eBroselow technology, every hospital, regardless of size, can make safe, quick preparation and administration of acute medications the standard.

eBroselow’s tools are not just for patients, but also for dedicated healthcare workers across the country, according to Dr. James Broselow, founder of eBroselow. “While technology cannot replace the human touch a caregiver offers, it can ensure accuracy and help them focus on the quality of care without having to second guess themselves.”

Until healthcare facilities can provide such medication safety, they cannot achieve high reliability in patient care. To do this, nurses need better clinical tools. eBroselow is dedicated to closing the gap between the status quo and error-free medication administration.

Prevalence of medication errors
Errors in medication preparation and administration include over and under dosing, inaccurate dilutions and rates, lack of consideration of indication, and delays in administering medications. Medication errors are the most common type of medical error in hospitals.

Medication errors often occur during acute drug administration, which still involves memory, searches in encyclopedic references, and manual calculations for dosing and preparing drugs in emergencies.

1 Milbank Q. 2013 Sep; 91(3): 459–490.
2 Institute of Medicine Report Brief, July 2006
3 Gokhman R, et al. Resuscitation. 2012;83:482-487

A study1 from researchers at the University of Pittsburgh School of Pharmacy revealed that, during medical emergencies in a large academic medical center, one out of two doses were administered in error. Studies also show that at least 25 percent of all harmful adverse drug events (ADE) are preventable, and each ADE adds about $9,924 to the cost of a hospital stay.4 Children and the elderly are most vulnerable when it comes to errors in acute drug administration. Depending on the drug, a 10-fold error for a premature infant—just a few extra milliliters—could be a fatal dose. According to the Patient Safety Movement Foundation , many health care systems are built around the needs of adults, and lack staff trained in pediatric care.

History of eBroselow
Designed for doctors, nurses, and pharmacists involved in acute care, eBroselow is a suite of products that eliminate manual math, ensure accuracy, and simplify complex processes to improve patient safety. The online and mobile system, Developed by Drs. James Broselow and Robert Luten, protects both adult and pediatric patients and ensures that the intention of the drug order is realized through accurate dosing and administration.

In the early 1980s, Dr. Broselow was an emergency room doctor who saw how difficult it was to treat children in the ER. He developed the Broselow Tape, a simple, but effective, color-coded tool that quickly provides proper dosing and airway information for children. Most emergency rooms in U.S. hospitals have adopted the Broselow Tape and color-coded crash carts as a standard of care for children in emergencies. Dr. Broselow received the Institute for Safe Medication Practices’ lifetime achievement award.

Dr. Luten has performed pioneering work in the field of emergency medicine, helping to create the specialty of pediatric emergency medicine in 1993. A professor at the University of Florida, Dr. Luten has spearheaded the development of curriculum and training materials for emergency care. His particular expertise is in emergency drug dosing and emergency airway management.

As drugs became more numerous and complex, Dr. Broselow saw the need for new clinical tools for treating both children and adults in acute care environments where seconds matter and stress compounds errors. In 2010, he and Dr. Luten partnered with the Pediatric Pharmacy Advocacy Group to develop the eBroselow Initiative, which serves as the underlying standard for the eBroselow software. The goal of the initiative is to develop a simple, safe, and effective international standard for acute medication preparation and administration

Dr. Broselow holds 12 patents related to safe emergency treatment of children.

4 Ford D, Luttrell N. Leadership in patient safety: IV pump auto-programming. Paper presented at: Cerner Health Conference; October 2009; Kansas City, MO. (Converted from 2006 to 2014 dollars at stats.areppim.com)

eBroselow eliminates medication errors and reduces risk
eBroselow products are designed to act as a safety net throughout the entire acute situation, providing the correct dosage, preparation, and delivery knowledge, and ensuring that the intended treatment is correctly communicated and properly administered.Researchers from the University of Kentucky demonstrated this in a 2014 study conducted at Kentucky Children’s Hospital.5 Their results showed that when medical practitioners used the eBroselow system, clinically significant errors were completely eliminated, and the accuracy of prepared medications increased by about 25 percent. In addition, medications were prepared about eight minutes faster with the eBroselow system versus standard dosing references.

eBroselow products

eBroselow Web
eBroselow’s dynamic website is browser-based and requires no plug-ins or specialized software. It works on any manufacturer-supported browser version of Internet Explorer, Firefox, or Safari.

Containing a comprehensive database of drugs and indications, eBroselow Web provides healthcare practitioners with critical clinical information in seconds so that they can deliver prompt, accurate treatment.

eBroselow Web is customizable with specific hospital drugs and concentrations, optimized for mobile use (see SafeDose Pro); includes algorithms/flowcharts, such as cardiac arrest flowchart and burns calculator; documents and coordinates care; and can integrate with Cerner and other electronic health record systems.

eBroselow SafeDose Pro™ (mobile version)
SafeDose Pro™ runs on any iOS or Android device, with an easy download from Apple or Google stores, and quick registration. Once loaded, it operates in airplane mode. This offers standardized acute medication administration at the point of care. In a hospital that has incorporated the eBroselow Hospital System as a standard, you can sync your eBroselow SafeDose Pro™ to match the hospital’s preferred concentrations.

eBroselow SafeDose Scan™ (barcode version)
SafeDose Scan™ is a handheld scanning device that puts the most comprehensive, up-to-date acute medication dosing and administration standard in the palm of your hand. By scanning the U.S. National Drug Code (NDC) barcode of acute medications, SafeDose Scan™ displays the contents of the vial as well as critical preparation, dosing and administration information for any patient—adult or child.

5 J Pediatr Pharmacol Ther 2014;19(3):174–181

SafeDose Scan™ operates offline and can serve as a backup in the event of a disaster or during power or system failure. SafeDose Scan™ can document administration of medications, sync with eBroselow Web, and be customized to your hospital drug formulary.eBroselow has recently partnered with Informs, a Honeywell reseller, to distribute SafeDose Scan™

eBroselow benefits:

  • Standardizing the delivery of critical knowledge for acute drugs and displaying it on a patented electronic page format
  • Removing error-prone manual math and memorization
  • Transforming an NDC barcode into instant drug administration knowledge.
  • Communicating physician intent in words (not just numbers) to medical personnel so that everyone can safeguard against errors.
  • Supporting one standard of care—days, nights, and weekends when less experienced nurses ?may be on duty, or when pharmacy support may not be available.
  • Customizing medication content to match hospital pharmacy formularies.
  • Enabling the pharmacy to instantly communicate drug shortages and substitutions.
  • Making critical knowledge accessible anywhere—at the bedside or during transport, with ?mobile access that is not Wi-Fi, Internet, or intranet dependent

eBroselow’s current capabilities:

  • Dose in mg /mcg
  • Dose in mL /tabs / caps
  • Dilution and reconstitution of medications
  • Delivery rate, titration ranges and administration information
  • Dangers: adverse reactions, Black Box and ISMP warnings
  • Y-site compatibilities for all IV medications
  • Algorithms for resuscitation, shock, sedation and agent titration (limited to eBroselow Web)
  • Burns calculator (limited to eBroselow Web)
  • Maximum intramuscular injection volumes (limited to eBroselow Web)
  • Links to reversal agents, supplemental and maintenance dosing (limited to eBroselow Web)

eBroselow database includes:

  • 22 categories for IV, PO, IM, nasal, and rectal dosing
  • Brand name and generic name drugs
  • Titration range soft limits
  • Exact weight dosing by indication for all weight-based drugs
  • Renal dosing for some antibiotics
  • Pharmacy mixing tool
  • Recalculation feature programmed to alert users if they exceed the ?manufacturer’s recommended maximum dose
  • FDA pregnancy drug categories

Other benefits of eBroselow

  • A single virtual page can be printed for the bedside, saved as PDF, emailed, or scanned via QR code.
  • eBroselow requires minimal IT support, and requires no hardware or network software installation, data exchange or interfaces with other systems.
  • eBroselow is easy to use and implement.
  • eBroselow can serve as a backup system for medication administration during hospital system outages.
  • eBroselow is HIPAA Compliant.
  • eBroselow also offers a Free Trial Program