Intrathecal baclofen pump refill monitoring: a quality improvement project for patient safety
George Marzloff, MD
George Marzloff,
Implantable intrathecal baclofen (ITB) pumps are commonly used to treat patients with severe spasticity. Baclofen is a medication that decreases spasms at the spinal cord level, and administration directly into the spinal fluid (i.e. intrathecal) allows for higher concentration to the spinal cord with minimal systemic effects.
Withdrawal can occur by suddenly stopping the drug administration, and may develop into a life-threatening emergency. Pumps are refilled typically as outpatient procedures; the schedule is determined by a patient's programmed flow rate. Upon device reprogramming after a refill, a "low reservoir alarm date" is automatically established, and staff schedules the next refill prior to that date.
As a MetroHealth Fellow in Spinal Cord Injury Medicine, I had the opportunity to work at the Louis Stokes Cleveland Veterans Administration Medical Center Spinal Cord Injury & Disorders department where we developed a quality improvement project to improve our monitoring of refill schedules to make sure patients' ITB pumps are refilled on time.