Using Smart Pumps to Understand and Evaluate Clinician Practice Patterns to Ensure Patient Safety

Mansfield, Jennifer; Jarrett, Steven

doi:10.1310/hpj4811-942

Cited by 20 publications

(15 citation statements)

References 5 publications

(10 reference statements)

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“…5 Drug library updates occur several times a year on schedule or when an issue warranting an immediate revision occurs. 10 This process Note: LSL = lower soft limit; UHL = upper hard limit; USL = upper soft limit.…”

Section: Case Reportmentioning

confidence: 99%

“…Executive score cards are created utilizing these data. 10 The score card provides an aggregate view of compliance rate and number of alerts, overrides, edits, and associated medications. The drug library revision process identifies additions or modifications that can enhance safety and potentially intercept future events.…”

Section: Optimizing Smart Pump Technologymentioning

confidence: 99%

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Optimizing Smart Pump Technology by Increasing Critical Safety Alerts and Reducing Clinically Insignificant Alerts

Mansfield

Jarrett

2015

Hosp Pharm

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Background:Alerts generated by intravenous (IV) infusion pump safety software prevent lifethreatening situations that might otherwise go unnoticed. However, when alerts are often clinically insignificant, health care workers may become desensitized and discount their importance, resulting in potentially dangerous situations. Little research has been devoted to visual alert desensitization. Method: This paper describes how the Carolinas HealthCare System decreased the number of nonclinically relevant infusion pump alerts by analyzing alert data that were formatted into scatter plots. This in turn enabled the identification of the medications associated with the most meaningful alerts and those associated with the least meaningful alerts. Conclusion: By revising drug library limits for specific medications, it was possible to decrease the number of less clinically meaningful alerts, reduce alert fatigue, and thereby increase the effectiveness of the smart infusion pumps. This added another layer of safety to patient care.

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Section: Case Reportmentioning

confidence: 99%

Section: Optimizing Smart Pump Technologymentioning

confidence: 99%

Optimizing Smart Pump Technology by Increasing Critical Safety Alerts and Reducing Clinically Insignificant Alerts

Mansfield

Jarrett

2015

Hosp Pharm

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“…First, the medication library needs to be well developed, meaning that alarms, both soft and hard, reflect optimal practice patterns for the organization's patient population. 5,7 Nuisance alarms generated by poorly developed medication libraries cause frustration and limit the adoption of the device safeguards. Engaging clinical experts in the ongoing review of medication administration dosages, infusion concentrations, and safe infusion parameters is essential in developing real-world medication libraries.…”

Section: Challenges and Work-aroundsmentioning

confidence: 99%

“…Accessing data from the smart pump overrides can provide rich data as to how the current medication library is functioning for patient safety and provided pointed opportunities for dose/range adjustments. 5,6,8 Clearly identifying override behaviors may also point to changes that need to occur farther up the IT medication processing system, such as the accuracy of CPOE medication elements. Reviewing medication usage data is also helpful to the CNS to objectively identify practice trends with specific medications and make mediation library adjustments accordingly.…”

Section: Challenges and Work-aroundsmentioning

confidence: 99%

Maximizing Smart Pump Technology to Enhance Patient Safety

Makic¹

2015

Clinical Nurse Specialist

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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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“…[3][4][5][6][7][8] One may consider this as a violation of his or her privacy, however, as Becnel 9 reports " . What you may not know about your routine is that you have left your electronic fingerprint in many database records.…”

Section: Your Electronic Fingerprintmentioning

confidence: 99%

Technology in Health Care

Quail¹

2015

Critical Care Nursing Quarterly

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Technology continues to evolve and improve making our everyday tasks appear sometimes routine and mundane. The health care industry has embraced technological advances to improve on its daily operations in an effort to run more efficiently. Health care providers must be aware that these technologies collect data, lots of data, which is discoverable and may be used to defend or refute your actions as a nurse. This article will take a closer look at health care technology, cell phones, medical equipment, social media, telematics, and Health Insurance Portability and Accountability Act requirements, so that you will become familiar with the information and electronic fingerprint left behind.

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Using Smart Pumps to Understand and Evaluate Clinician Practice Patterns to Ensure Patient Safety

Abstract: A review of the data about medication safety across CHS has helped garner support for a medication safety officer position with the goal of ultimately creating a safer environment for the patient.

Cited by 20 publications

References 5 publications

Optimizing Smart Pump Technology by Increasing Critical Safety Alerts and Reducing Clinically Insignificant Alerts

Optimizing Smart Pump Technology by Increasing Critical Safety Alerts and Reducing Clinically Insignificant Alerts

Maximizing Smart Pump Technology to Enhance Patient Safety

Technology in Health Care

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