Nurse and Pharmacist Knowledge of Intravenous Smart Pump System Setup Requirements

Overview

Journal Biomed Instrum Technol

Specialty Biomedical Engineering

Date 2021 Mar 22

PMID 33751021

Citations 1

Authors

Karen K Giuliano

Jeannine W C Blake

Affiliations

Soon will be listed here.

Abstract

Objective: The primary purpose of this research was to describe nurse and pharmacist knowledge of setup requirements for intravenous (IV) smart pumps that require head height differentials for accurate fluid flow.

Methods: A secondary analysis of anonymous electronic survey data using a database of prerecruited clinicians was conducted. A survey was sent by email to 173 pharmacists and 960 nurses. The response rate for pharmacists was 58% (100 of 173), and the response rate for nurses was 52% (500 of 960). After removing respondents who did not provide direct care and who did not use a head height differential IV infusion system, the final sample for analysis was 186 nurses and 25 pharmacists.

Results: Overall, less than one-half of respondents (40%) were aware that manufacturer guidelines for positioning the primary infusion bag relative to the infusion pump were available. Slightly more (49.5%) were aware of the required head height differentials for secondary infusion. Only five respondents selected the correct primary head height, eight respondents selected the correct secondary head height, and one respondent selected both the correct primary and secondary head heights.

Conclusion: The results of this study identify a substantial lack of knowledge among frontline clinicians regarding manufacturer recommendations for accurate IV administration of primary and secondary infusions for head height differential infusion systems. Both increased clinician education and innovative technology solutions are needed to improve IV smart pump safety and usability.

Citing Articles

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review.

Ahmed A, Tanveer M, Shrestha S, Khatiwada A, Khanal S, Dujaili J Healthcare (Basel). 2022; 10(9).

PMID: 36141242 PMC: 9498522. DOI: 10.3390/healthcare10091630.

References

Nuckols T, Bower A, Paddock S, Hilborne L, Wallace P, Rothschild J . Programmable infusion pumps in ICUs: an analysis of corresponding adverse drug events. J Gen Intern Med. 2008; 23 Suppl 1:41-5. PMC: 2150642. DOI: 10.1007/s11606-007-0414-y. View

Ohashi K, Dykes P, Mcintosh K, Buckley E, Wien M, Bates D . Evaluation of intravenous medication errors with smart infusion pumps in an academic medical center. AMIA Annu Symp Proc. 2014; 2013:1089-98. PMC: 3900131. View

Gorski L, Hadaway L, Hagle M, Broadhurst D, Clare S, Kleidon T . Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021; 44(1S Suppl 1):S1-S224. DOI: 10.1097/NAN.0000000000000396. View

Fahimi F, Ariapanah P, Faizi M, Shafaghi B, Namdar R, Ardakani M . Errors in preparation and administration of intravenous medications in the intensive care unit of a teaching hospital: an observational study. Aust Crit Care. 2008; 21(2):110-6. DOI: 10.1016/j.aucc.2007.10.004. View

Dammann K, Timmons M, Edelman M, Pierce C, Higdon E, Bernard A . Electrolyte Analysis and Replacement: Challenging a Paradigm in Surgical Patients. J Trauma Nurs. 2020; 27(3):141-145. DOI: 10.1097/JTN.0000000000000502. View

Kuitunen S, Niittynen I, Airaksinen M, Holmstrom A . Systemic Causes of In-Hospital Intravenous Medication Errors: A Systematic Review. J Patient Saf. 2020; 17(8):e1660-e1668. PMC: 8612891. DOI: 10.1097/PTS.0000000000000632. View

Cassano-Piche A, Fan M, Sabovitch S, Masino C, Easty A . Multiple intravenous infusions phase 1b: practice and training scan. Ont Health Technol Assess Ser. 2012; 12(16):1-132. PMC: 3377572. View

Ohashi K, Dalleur O, Dykes P, Bates D . Benefits and risks of using smart pumps to reduce medication error rates: a systematic review. Drug Saf. 2014; 37(12):1011-20. DOI: 10.1007/s40264-014-0232-1. View

Giuliano K . Intravenous Smart Pumps: Usability Issues, Intravenous Medication Administration Error, and Patient Safety. Crit Care Nurs Clin North Am. 2018; 30(2):215-224. DOI: 10.1016/j.cnc.2018.02.004. View

10.

Rout J, Essack S, Brysiewicz P . Are nursing infusion practices delivering full-dose antimicrobial treatment?. J Antimicrob Chemother. 2019; 74(12):3418-3422. DOI: 10.1093/jac/dkz365. View

11.

Rothschild J, Keohane C, Cook E, Orav E, Burdick E, Thompson S . A controlled trial of smart infusion pumps to improve medication safety in critically ill patients. Crit Care Med. 2005; 33(3):533-40. DOI: 10.1097/01.ccm.0000155912.73313.cd. View

12.

Schnock K, Dykes P, Albert J, Ariosto D, Call R, Cameron C . The frequency of intravenous medication administration errors related to smart infusion pumps: a multihospital observational study. BMJ Qual Saf. 2016; 26(2):131-140. DOI: 10.1136/bmjqs-2015-004465. View

13.

Kane-Gill S, Kirisci L, Verrico M, Rothschild J . Analysis of risk factors for adverse drug events in critically ill patients*. Crit Care Med. 2011; 40(3):823-8. PMC: 3581340. DOI: 10.1097/CCM.0b013e318236f473. View

14.

Schnock K, Dykes P, Albert J, Ariosto D, Cameron C, Carroll D . A Multi-hospital Before-After Observational Study Using a Point-Prevalence Approach with an Infusion Safety Intervention Bundle to Reduce Intravenous Medication Administration Errors. Drug Saf. 2018; 41(6):591-602. DOI: 10.1007/s40264-018-0637-3. View

15.

Giuliano K, Penoyer D, Mahuren R, Bennett M . Intravenous Smart Pumps During Actual Clinical Use: A Descriptive Comparison of Primary and Secondary Infusion Practices. J Infus Nurs. 2021; 44(3):128-136. PMC: 8096316. DOI: 10.1097/NAN.0000000000000415. View

16.

Pin-On P, Saringkarinkul A, Punjasawadwong Y, Kacha S, Wilairat D . Serum electrolyte imbalance and prognostic factors of postoperative death in adult traumatic brain injury patients: A prospective cohort study. Medicine (Baltimore). 2018; 97(45):e13081. PMC: 6250545. DOI: 10.1097/MD.0000000000013081. View

17.

Husch M, Sullivan C, Rooney D, Barnard C, Fotis M, Clarke J . Insights from the sharp end of intravenous medication errors: implications for infusion pump technology. Qual Saf Health Care. 2005; 14(2):80-6. PMC: 1743987. DOI: 10.1136/qshc.2004.011957. View