Maximizing Smart Pump Technology to Enhance Patient Safety

Abstract

SMART PUMP TECHNOLOGY Infusion pumps are defined by the US Food and Drug Administration as an external medical device used to deliver fluids into a patient's body in a controlled manner. 1 Smart pump infusion technology encompasses a variety of intravenous infusion devices with built-in computers containing electronic libraries of information on selected drugs and fluids with corresponding administration dose/rate limits. 2,3 Smart pump technology was introduced into clinical practice in the early 2000s and has continued to grow in the technology's role in reducing patient harm associated with medication administration. Strategies to mitigate errors across the medication pathway of prescribing, transcribing, dispensing, administration, and documentation have been implemented. However, more than half of reported medication errors occur during the final step of administration. 2 Thus, the emerging technology of a smart pump incorporates fluid/drug administration recommendations and alarms to alert the nurse to real or potential administration errors during the programming of the pump, assisting with the safety of that final step of medication administration. However, smart pumps are not very smart on their own 4 ; the technology depends on the active use of the medication libraries within the pump on a consistent basis. Maintaining an accurate medication library is an essential piece to the successful and complete adoption of smart pump infusion technology in practice. The clinical nurse specialist (CNS) plays a vital role in providing essential information to maintain the medication library, assisting with maximal smart pump technology use in practice, and obtaining reports demonstrating the effectiveness of the device in reducing patient harm. ADVANTAGES OF SMART PUMP TECHNOLOGYOne of the largest advantages of smart pump technology is the electronic database within the pump that provides instant drug administration information at the point of care. 3,5Y7 In addition, specific alarms and drug dosing limitations can be programmed into the device, facilitating medication safety. ''Soft'' limits can be set, alerting the nurse to the fact that the medication dosage is out of range for typical therapy. When a soft limit is sensed, the device will alarm and wait for the clinician to address the alert by either overriding the alarm or adjusting the dosing programming within the recommended medication library parameters within the smart pump. ''Hard'' limits are programmed to prevent dosing parameters beyond the recommended dose. 3,5Y7 When a hard limit alarm is triggered, the infusion will not initiate, and the nurse will need to either adjust the dose to be within the programmed limit or cancel the infusion. These 2 features are believed to be essential in preventing medication errors that may be caused by incorrect manual drug calculations or manual programming errors. 7 Another advantage of smart pump technology is the matching of medication bar coding and infusion pump drug identification. 7 Matching the medication b...

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