Smart Pumps: Maximizing safety through effective design and training

Abstract

Smart pumps have the potential to reduce medication administration errors by alerting users to potential dosing errors. However, achieving the safety benefits of smart pumps have been challenging for many hospitals. Smart pump implementations are often treated as pump replacement projects instead of safety initiatives, which require a larger coordinated effort with stakeholders throughout the medication administration process.

To address this issue, the authors published a roadmap to optimize smart pump implementations. The authors have subsequently completed a supplementary report to help hospitals understand how smart pump design and user training impact nurses’ ability to safely and efficiently deliver intravenous medications.

Two lab studies were conducted in simulated clinical environments. The first study examined the impact of design features of three commercially available smart pumps on nurses’ performance. The second study compared the impact of traditional vendor training to human factors and education informed training on nurses’ performance.

Nurses’ ability to safely deliver intravenous medications was significantly affected by smart pump design; key design features were found to augment safety (e.g., defaulting users into the drug library, informative and salient limit messages). However, no significant differences in safety were found between training curricula. These results reinforce the notion that medication error prevention strategies that change the system (i.e., design oriented) are more effective than those that rely on human vigilance and memory (e.g., training).

A series of recommendations will be presented to assist hospitals during their smart pump procurement process and in designing their user training programs.