Smart pump alerts: All that glitters is not gold

IntroductionThe implementation of smart pump technology can reduce the incidence of errors in the administration of intravenous drugs. This approach involves developing drug libraries for specific units and setting hard and soft limits for each drug. If a programming error occurs and these limits are exceeded, an alarm sounds and the infusion can be blocked. A detailed analysis of these alarms is essential in order not to bias the results in favor of a positive impact of this technology.PurposeTo evaluate the results of the first analysis of the use of smart infusion pumps and to assess the significance and practical implications of the alarms sounded.MethodsThe study was performed by a multidisciplinary team that consisted of a clinical pharmacist, a pediatrician from the pediatric intensive care unit (PICU), and the chief nurse of the unit. A library of 108 drugs was developed over a 7-month period and introduced into 40 syringe pumps and 12 volumetric pumps (Alaris® with Plus software) before being applied in 6 of the 11 beds in the PICU. After four month's use, data were analyzed using the Guardrails® CQI v4.1 Event Reporter program.ResultsFollowing the first four months of implementation, compliance with the drug library was 87%. By analyzing the alerts triggered, we were able to detect problems such as the need to increase user training, readjust limits that did not correspond to clinical practice, correct errors in the editing of the drug library and including a training profile.ConclusionIt is difficult to obtain accurate data on the true impact of this technology in the early stages of its implementation. This preliminary analysis allowed us to identify improvement measures to distinguish, in future evaluations, the alarms triggered by a real programming error from those caused by incorrect use.

► Smart pump technology has shown to be effective in avoiding administration errors.
► The development of a practical drug library is key to the success of this technology.
► Information gathered in the first months of implementation can help to improve the quality of the drug library and to detect early usersî training needs.
► An exhaustive analysis of the alarms triggered allows to refine the technology and to distinguish alarms associated with real errors from the irrelevant ones.