Clinical Data Explanation: Investigating alerts with VTBI=0.00

Question

How can I find out about VTBI values for alerts in the Investigative Report that show VTBI= 0.00?

Answer

When IPI shows an alert in an Investigative Report, the information for the alert comes from a row in the "All Available Columns" spreadsheet that identifies the action taken for that alert (override, reprogram, cancel). Sometimes that single row does not contain all the information captured by the smart pump about the sequence of actions taken by the nurse when programming the infusion.that triggered the alert.

Let's look at the spreadsheet for the Indianapolis VAMC May 2014, This spreadsheet was downloaded from an IPI investigative report after filtering the VTBI column for VTBI=0.00. Note that there are 138 (of 538 total alerts) that show VTBI=0.00.

More information about VTBI values for each of these 138 alerts can be found in other rows from the All Available Columns -- captured by the smart pump for the sequence of infusion actions that triggered this alert. . The other rows provide valuable information that you want to know about, like values for VTBI..

We now can show you all rows describing the full sequence of actions for every alert . This new feature lets you click on any drug name in an investigative report to see the full sequence of rows for that infusion from All Available Columns..

We will use this new feature to drill-down on drug names for investigative report alerts with VTBI=0.00.

Screenshots explain how ...

Click images to enlarge.

Step 1: Select parameters for the VAMC above/below limit all types investigative report.	Step 2: Generate the report for above/below limit all types.
Step 3: Filter VTBI column for VTBI=0.00, i.e., zero values only.Notice the = sign before the 0.00 in the VTBI column filter.	Step 4: Scroll back to first column of the investigative report. Now double click on the drug name bevacizumab, and you get a pop-up window with all the rows from the All Available Columns that are part of the sequence of actions for this infusion.
Step 5: Scroll in your pop-up window over to the VTBI  column for the 2 data rows of information about this alert. Note that there are values for VTBI and infusion rate.You can study the data then click the "x" in the upper right of the pop-up window to close it.	Step 6: Scroll back to first column of the IPI investigative report. This time, double click on the drug name etoposide. Again, you will get a pop-up window that shows you the full sequence of actions for this infusion as rows from the All Available Columns. Notice that there are 3 rows for actions from this alert.
Step 7: Scroll popup over to VTBI for 3 data rows of info. Study the data (including VTBI values) and close the pop-up when done.	Step 8: Scroll back to first column of the investigative report. Double click on the drug name mesna.
Step 9: Scroll popup over to VTBI for 4 data rows of information about the action sequence for this alert. Close the pop-up when done..   .