15 Sep UW Hospital and Clinics install ‘smart’ intravenous pumps
MADISON, Wis. — A nurse keys a 10-milliliter-per-hour dose of insulin into a patient’s intravenous infusion pump but makes a simple mistake, accidentally keying in an overdose of 100 milliliters per hour. Another patient is supposed to receive 25 ml of a different drug, but a miscalculation unleashes 250 milliliters by mistake.
Errors like these occur every day in hospitals across the country, sometimes placing patients at risk of serious harm. Sixty percent of the harmful medication errors that occur in hospitals are related to IV infusion pumps.
Eliminating these errors is the reason the University of Wisconsin Hospital and Clinics has installed a new medication safety system developed by San Diego-based Alaris Medical Systems Inc. The system, also called a “smart” infusion system, features a software program that provides computerized decision support to nurses and physicians at the patient’s bedside, helping to prevent serious dosing errors.
“What this new technology does is to put a smart drug library into the infusion pump, so that based on which drug the nurse tells the pump she’s about to administer, the pump alerts her if she inadvertently exceeds a pre-established minimum or maximum dosing allowance for the medication,” said Susan Kleppin, a senior clinical pharmacist with UW Hospital and Clinics. “The system provides an extra layer of protection by alerting the clinician when a programmed dose is outside pre-established dosage limits for that medication, thus helping to prevent a wrong dose from being administered to the patient.”
UW Hospital and Clinics is among a handful of hospitals nationwide to implement “smart” infusion pump technology, and one of the first hospitals in the country to receive money from the U.S. Agency for Healthcare Research and Quality to study the patient benefits of the technology.
“We invested in this ‘smart’ system because it assists in preventing inappropriate medication dosing, protects patient safety and is helping us to improve our safety strategies,” says Steve Rough, director of pharmacy services at UW Hospital and Clinics. “Every hospital will eventually be required to have technology like this.”
Nurses, pharmacists and physicians at UW Hospital and Clinics collaborated to create six different computerized profiles containing drug libraries for users to access—medical/surgical, pediatric, pediatric ICU, adult ICU, cardiac and intermediate care. Depending on the area of the hospital in which the pump is being used, the nurse simply selects the appropriate drug library and accesses information about the drugs appropriate for use in that area. The pumps debuted in October 2003; 650 programming units and 900 pumping modules are now in use in all 26 units of the hospital.
The reaction among nurses has been very positive, said Tracy Love, program manager of IV pump systems at UW Hospital and Clinics. She noted that the bedside decision support makes them feel more confident about patient safety and better able to focus on other aspects of delivering patient care.
“Smart” infusion pump technology represents the next step in a series of patient-safety initiatives at UW Hospital and Clinics. In 2001, UW Hospital and Clinics was one of the first in the nation to implement AdminRx, a bar-code scanning system also designed to reduce medication-administration errors. Eventually, Smart Pumps will integrate with AdminRx, creating yet another layer of safety.
Not only does “smart” infusion technology provide a visual message to alert the user of a potential error, but an easy-to-read ticker also scrolls the name of the drug and the dose infusing across the pump display, allowing nurses to see exactly what drug and how much is being administered. The pumps are modular, allowing for up to four different types of drugs to be dispensed from a single unit.
“When you go to a pharmacy, the pharmacist processes your prescription using a computer to check for allergies and drug interactions. “‘Smart’ pumps provide a similar level of support at the patient’s bedside,” Rough said.
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Aaron Conklin from UW Communications can be contacted at ar.conklin@hosp.wisc.edu.