Harder Drug Dose Limits Urged for Safer Smart Pump Technologies

January 17, 2014

January 17, 2014

Cleveland Clinic and The Indiana University Health (IUH) system overhauled their procedures for establishing safe drug dosing ranges in “smart” IV infusion pumps and communicating the new ranges to key personnel.

global_industry"The overall goal is to improve safety and reduce errors during the IV administration process by making it difficult for users to do the wrong thing. The only way to do this is [via] hard limits,"said Cleveland Clinic pharmacist SilvanaBalliu, PharmD.

Dr. Balliu and her colleagues reviewed their smart pump data at the Cleveland clinic. They discovered that to administer boluses of heparin from the IV bag, clinicians had intermittently programmed short, continuous infusions of up to 90,000 units per hour. Dr. Balliu stated that these doses were "way too high."

The more stringent programmed dosing measures decreased the possibility of IV drug administration errors and alert fatigue. Whenever soft drug limits are exceeded, the IV pumps generate alerts too often than necessary. Dr. Balliuexplained that if alerts come too often, they may not be treated as if they are clinically significant.

The (IUH) system experienced errors when patients were transferred between IUH facilities "due to different pump hardware and software versions, different data sets, different dosing units, different drug concentrations," said Jennifer Reddan,PharmD, Director of the Center for Medication Management at IUH. The length of time it takes to capture and upload pump data set changes also caused errors. Delays occurred because not all practitioners realized that smart pumps must be manually updated, Dr. Reddan noted.

To address this issue, IUH designated the third Wednesday of each month as "Pump Safety Day." During this exercise,the hospital pharmacy manager releases a new data set over the server, alerting clinicians to update pumps. "Establishing a multidisciplinary smart pump group is a key way hospitals can improve the setting and implementation of limits," Dr. Reddan said.

To ensure the success of these new measures and procedures, clinics, hospitals and other healthcare facilities must use only well-serviced infusion pump systems.

About the Author

Laura Collier

Laura Collier

Laura Collier has a Bachelor’s Degree in Communications and a Master’s Degree in Business Administration from the University of North Florida. She is the Marketing Manager at AIV, Inc.

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