Applying Smart Pump Data to Improve Safety at the Bedside

Purpose:
To describe methods for maximizing the full potential of smart pump technology in the way it is designed to be used to improve quality and patient safety at the bedside.

Significance:
In April 2010 the FDA announced their "Infusion Pump Improvement Initiative" to proactively provide regulations for the development of safer more effective infusion pumps across the industry; further increasing the expectation for appropriate use of smart pump technology to protect the patient.

Strategy and Implementation:
In 2011 University Hospitals deployed smart pump technology system-wide throughout 15 facilities; inpatient (adult and pediatric), outpatient/ambulatory care, oncology and surgery centers. Compliance goal was set at 80-90% for all infusions. A medication safety officer, informatics officer and clinical IT analyst manage the drug library, track compliance and report out on continuous quality improvement (CQI) data for 2,200 devices. The CQI data provides extensive alert detail for when drug dose, drug concentration or rate of administration is outside the minimum and/or maximum guardrail safety limit. Each month a nursing division dashboard and #1 drug alert data report is produced for managers to share with their staff. The dashboard highlights which medication for that division produces the highest number of alerts allowing each clinical manager to identify practice issues, dangerous trends and drug library modifications for the quarterly system update.

Evaluation:
Improved compliance with drug library utilization, decreased number of drug alerts, and increased number of harm avoidance cases are used to measure success.

Implications for Practice:
Smart pumps are used by healthcare institutions worldwide. When utilized to the fullest extent of the technology design, smart pumps can significantly improve safety at the bedside. A simplified approach to application of pump data by nursing staff raises awareness to support use and reduce risk.