TITLE: REDUCING TOTAL COSTS OF AEROSOLIZED MEDICATION DELIVERY USING THE AEROECLIPSE II BREATH ACTUATED NEBULIZER
AUTHOR: Wilson, John1
INSTITUTION: 1. Cardiopulmonary Services, Forsyth Medical Center, Winston Salem, NC, United States.
Abstract body: Introduction:
We hypothesized the AeroEclipse II breath actuated nebulizer combined with an aggressive dosing and frequency protocol would result in cost savings.
We transitioned a 38 bed pulmonary unit from traditional jet nebulizers to BAN nebulizers and developed a medication dosing and frequency protocol. Albuterol was converted to 0.5 ml of a 0.5% solution with 1ml normal saline. Atrovent was converted to one half unit dose. The breath actuated mode via mouthpiece or mask interface with normal saline increased to 2 ml and continuous mode was used. Frequencies were changed from Q4 to Q6 and QID to TID. BANs were changed weekly versus daily with traditional nebulizers. Average hourly rate, treatment time, drug costs, and device costs for June through November 2008 were compared to 2007. To ensure effectiveness of therapy we compared the average number of both scheduled and PRN treatments per patient per day. Subsequently, we utilized this model to convert all impatient beds to BAN in June 2010 and compared data to a similar time period in 2009.
Our initial 2008 conversion resulted in a 20% decrease in total costs with an annualized savings of $52,360. Additionally a 31% decrease in minutes per day in therapist time to administer medications and 21% increase in duration between treatments was realized. The average number of scheduled treatments per patient per day was 3.4 and 2.8 in 2007 and 2008 respectively while the average number of PRN treatments was 0.16 and 0.15 in 2007 and 2008 respectively. In the 2010 analysis BAN nebulizers account for an 18% decrease in total costs, and a 19% decrease in total treatment time. Use of BAN nebulizers resulted in an annual savings at Forsyth Medical Center of $186,789 and estimated savings of $475,411 across Novant Health facilities. Average number of scheduled treatments per patient per day was 3.3 and 3.1 in 2009 and 2010 respectively while the average number of PRN treatments was 0.24 and 0.27 in 2007 and 2008 respectively. Additionally, we compared 2010 data from the units in our initial 2008 group to ensure the improvement reported was maintained in that area.
Using the AeroEclipse II breath actuated nebulizer in conjunction with an aggressive medication dosing and frequency reduction protocol provides significant savings. Greater gains have been realized for the pulmonary specific unit which treats patients with more severe pulmonary conditions.
PRESENTATION TYPE: Method, device, or protocol evaluation