Implementation of smart pump technology in a paediatric intensive care unit

Manrique-Rodríguez, Silvia; Sánchez-Galindo, Amelia; Lorenzo-Pinto, Ana de; González-Vives, Leticia; López‐Herce, Jesús; Carrillo-Álvarez, Ángel; Sanjurjo‐Sáez, María; Fernández-Llamazares, Cecilia M.

doi:10.1177/1460458213518058

Cited by 15 publications

(16 citation statements)

References 22 publications

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“…In our NICU, most alarms occurred around 10:00–11:00 a.m. and around 4:00–5:00 p.m., which coincide respectively with the time when the neonatologists change the treatment prescriptions and the period after the change in nursing shift, when the nurses start administering the medication. This differs from other studies, in which the time of greatest error coincides with the change in nursing shift or with other medication administration times [ 17 , 19 ]. The months in which most alarms were detected due to attempts to exceed the relative and absolute limits in the programming of intravenous medication were January and February 2014, twice as many as in the other months of the year.…”

Section: Discussioncontrasting

confidence: 80%

Smart pumps and random safety audits in a Neonatal Intensive Care Unit: a new challenge for patient safety

et al. 2015

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BackgroundRandom safety audits (RSA) are a safety tool enabling prevention of adverse events, but they have not been widely used in hospitals. The aim of this study was to use RSAs to assess and compare the frequency of appropriate use of infusion pump safety systems in a Neonatal Intensive Care Unit (NICU) before and after quality improvement interventions and to analyse the intravenous medication programming data.MethodsProspective, observational study comparing the frequency of appropriate use of Alaris® CC smart pumps through RSAs over two periods, from 1 January to 31 December 2012 and from 1 November 2014 to 31 January 2015. Appropriate use was defined as all evaluated variables being correctly programmed into the same device. Between the two periods they were established interventions to improve the use of pumps. The information recorded at the pumps with the new security system, also extracted for one year.ResultsFifty-two measurements were collected during the first period and 160 measurements during the second period. The frequency of appropriate use was 73.13 % (117/160) in the second period versus 0 % (0/52) in the first period (p < 0.0001). Information was recorded on 44,924 infusions; in 46.03 % (20,680/44,924) of cases the drug name was recorded. In 2.5 % (532/20,680) of cases there was an attempt to exceed the absolute limit.ConclusionsRandom Safety Audits were a very useful tool for detecting inappropriate use of pumps in the NICU. The improvement strategies were effective for improving appropriate use and programming of the intravenous medication infusion pumps in our NICU.

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Section: Discussioncontrasting

confidence: 80%

Smart pumps and random safety audits in a Neonatal Intensive Care Unit: a new challenge for patient safety

et al. 2015

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“…Where students achievement for self-efficacy and knowledge related to quality and safety competencies skill is often accomplished at different rates students. This was evident from the Table 2 that illustrated a high percentage of use of safety software in our study (92%) of success and compliance .This is corresponding with [14] and [15] who mentioned that infusions administration by using smart pumps with the drug library program is the key of success in preventing programming errors from reaching patients and compliance with the technology implementation was 92% and user acceptance was high. This also was in agreements was [16] who stated that student training achievements using role-play simulation play an important role in developing critical thinking skills and experience.…”

Section: Discussionsupporting

confidence: 66%

Plan-Do-Check-Act Framework: Effects on Pediatric Students Nurses Compliance toward Using Intravenous Smart Pump

Allam

AlSadhan²

2019

AJPR

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Background: Using Intravenous Smart Pump by pediatric nursing students has shaped the challenge of finding innovative ways to teach clinical skills. The study aimed to assess the effect of PDSA framework on pediatric nurses compliance in using smart pump technology for intravenous medication administration in the pediatric intensive care unit. Design: A Quasi-Experimental quantitative, pre/post-test design was used to conduct the study. A purposive sample of 90 pediatric nursing students chosen based on the simple random sample for the academic year 2016– 2017, participated in the study. Methods: Three tools were designed by the researchers to collect the necessary data to implement the Plan Do Study Act (PDSA) framework. Statistical Analysis: The collected data were coded, analyzed and tabulated using frequencies and percentage, mean, standard deviation & chi-square tests. Results: There was a statistically significant difference and marked improvement in nurses students’ total knowledge and skills levels of smart pump intravenous administration (Pre and Post Plan Do Study Act (PDSA) framework) pre/post periods of assessment. It was observed that the majority of studied sample had good scores (100%, 97.8%, 97.8% & 93.3%) respectively post-intervention compared to (73.3%, 64.5%, 52.2%, 36.7%, 16.7%, 13.3%) pre-program and respectively (p<0.01). Conclusion: Administration of intravenous therapy for neonates can be risky but when supported by the use of smart pump systems with proper programming, compliance nurses students and staff education by reporting, monitoring, it will be a valuable tool to avoid actually catastrophic damage related to medication and infusion errors. Recommendation: Collaboration between health professionals is the key of successful implementation of smart infusion pump technology which can improve patient safety.

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“…The continuous administration of inotropic and vasoactive drug solutions needs high accuracy infusion devices. For safety on drug administration and a reduction in a infusion pump drug errors, the ISMP recommended the use of smart pumps that may be used with standard solutions to support a safer medication manager …”

Section: Introductionmentioning

confidence: 99%

“…For safety on drug administration and a reduction in a infusion pump drug errors, the ISMP recommended the use of smart pumps that may be used with standard solutions to support a safer medication manager. [10][11][12][13] Despite some successful outcomes with the use of standard solutions to prevent medication error, there is still no consensus on its use, and in Brazil, the method is pioneering.…”

Section: Introductionmentioning

confidence: 99%

Standard concentration infusions of inotropic and vasoactive drugs in paediatric intensive care: a strategy for patient safety

Barreto¹,

Sestren²,

Boergen-Lacerda

et al. 2019

Journal of Pharmacy and Pharmacology

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Objectives To evaluate the advantages and disadvantages of using different standard concentration infusions for high‐alert inotropic and vasoactive drugs in paediatric intensive care units (ICUs). Methods Retrospective data analysis was performed on drug prescriptions for patients in paediatric ICUs. A matrix was developed based on optimal concentration recommendations for each drug, taking into consideration solution stability and patient safety. Hypothetical volumes were calculated for three standard solutions (high concentration – HC, low concentration – LC and fluid restriction – FR) and compared to the actual administered volumes to evaluate the impact of the volumes of each standard solution for varying weight ranges in paediatric care. Finally, a risk assessment of the standard infusions was conducted using the NPSA 20 tool along with an assessment of the pharmacoeconomic impact. Key findings The results suggest the need for at least two standard concentrations for each of the studied drugs in order to attend to the different weight ranges and clinical conditions of paediatric patients in intensive care. Conclusions High concentration is ideal for patients up to 20 kg. For patients over 20 kg, FR is recommended, while LC should only be used in specific situations. Modifying the hospital pharmacotherapy system to include standard solutions is safer and reduces the risks of adverse effects. The pharmacoeconomic analysis did not show any impact on costs, although a reduction in adverse effects should be considered.

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Implementation of smart pump technology in a paediatric intensive care unit

Cited by 15 publications

References 22 publications

Smart pumps and random safety audits in a Neonatal Intensive Care Unit: a new challenge for patient safety

Smart pumps and random safety audits in a Neonatal Intensive Care Unit: a new challenge for patient safety

Plan-Do-Check-Act Framework: Effects on Pediatric Students Nurses Compliance toward Using Intravenous Smart Pump

Standard concentration infusions of inotropic and vasoactive drugs in paediatric intensive care: a strategy for patient safety

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