Improving Infusion Pump Safety Through Usability Testing

Miller, Kristen; Arnold, Ryan; Capan, Müge; Campbell, Michele; Zern, Susan Coffey; Dressler, Robert; Duru, Ozioma O.; Ebbert, Gwen; Jackson, E. Atlee; Learish, John; Strauß, D. G.; Wu, Pan; Bennett, Dean A.

doi:10.1097/ncq.0000000000000208

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…In addition to a heuristic assessment, a facility may also consider hiring a human factors scientist to conduct full-scale usability testing in a simulated clinical environment with frontline staff. 26,30 The information gathered from this type of testing may help to elucidate and confirm hypotheses generated from a heuristic assessment. 23,31 Overall, input from a knowledgeable human factors scientist likely will generate highly valuable information that will help to inform the procurement of a well-designed infusion pump and mitigate risk of an adverse event.…”

Section: Safety Strategiesmentioning

confidence: 99%

“…Alternatively, the team may reveal that a simple adjustment of a setting on the device could significantly reduce the likelihood of a use error (e.g., use of hard limits rather than soft limits). 21,30,40 As another possible solution, the team may recommend developing a staffwide training program with concrete strategies to reduce the likelihood of a specific use error. 30,38,[41][42][43] Although training can be effective, engineering controls or design-oriented strategies are often more reliable in preventing a use error.…”

Section: Leverage Event Log Data From Pumpsmentioning

confidence: 99%

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Risk of Medication Errors With Infusion Pumps

Taylor¹,

Jones²

2019

PatientSaf

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The risk of medication errors with infusion pumps is well established, yet a better understanding is needed of the scenarios and factors associated with the errors. Our study explored the frequency of medication errors with infusion pumps, based on events reported to the Pennsylvania Patient Safety Reporting System (PA-PSRS) during calendar year 2018. Our study identified a total of 1,004 events involving a medication error and use of an infusion pump, which occurred at 132 different hospitals in Pennsylvania. Fortunately, a majority of medication errors did not cause patient harm or death; however, we did find that 22% of events involved a high-alert medication. Our study shows that the frequency of events varies widely across the stages of medication process and types of medication error. In a subset of our data, we manually reviewed a free-text narrative field in each event report to better understand the nature of errors. For example, we found that a majority of wrong rate errors led to medication being infused at a faster rate than intended, and user programming was the most common contributing factor. Overall, results from our study can help providers identify areas to target for risk mitigation related to medication errors and the use of infusion pumps.

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Section: Safety Strategiesmentioning

confidence: 99%

Section: Leverage Event Log Data From Pumpsmentioning

confidence: 99%

Risk of Medication Errors With Infusion Pumps

Taylor¹,

Jones²

2019

PatientSaf

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“…A study conducted at the Christiana Care Health System Virtual Education and Simulation Training Center through a usability test with IP simulation observed, indirectly, that 68% of its participants had failures when handling IP; 86% after performing a self-assessment revealed that they experienced usability problems during the simulated test. The results of this simulation evidenced vulnerabilities and potential opportunities for improvement in IP; for instance, it was pointed out that multifunctional keys made its usability difficult (22) .…”

Section: Resultsmentioning

confidence: 99%

Usability of volumetric infusion pumps in pediatric intensive care

Oliveira

Silva

Arruda

et al. 2021

Rev. esc. enferm. USP

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Objective: To analyze the usability of two infusion pump models in a Pediatric Intensive Care Unit. Method: This is a cross-sectional study of exploratory descriptive quantitative approach. A task was carried out in a controlled environment using infusion pump with 72 nursing staff members from August to September 2018. The Methodological Guideline for Medical Care Equipment Assessment Studies and the quality model proposed by NBR ISO/IEC 9126-1 were followed. Descriptive statistical analysis was used applying Fisher’s exact test, binomial test and Mann-Whitney test. Results: 91.7% of tasks were completed. The infusion pump-2 model was associated (p < 0.001) with operationalization, tasks accomplished with non-conformities, use of a manual calculator (measure effectiveness) and task accomplishment time (measure efficiency). Conclusion: Efficacy and efficiency measures can evidence a better context of usability of IPs and identify interaction failures with the nursing staff to be improved in care practice.

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“…However, we did not discuss the difference in performance between each PFSP in that study. In this study, we determined that the time extension ratio of various PFSPs is not determined by a particular infusion set or PFSP, but rather depends on the handling technique of the medical staff using the equipment [ 13 – 15 ]. PVC infusion sets rely heavily on plasticizers such as tris(2-ethylhexyl) trimellitate (TOTM) to maintain their softness.…”

Section: Discussionmentioning

confidence: 99%

Influence of technique used to attach the infusion set to peristaltic finger smart-pumps on dispensing time: an experimental study

Umemura

Maegawa

Arai

et al. 2018

J Pharm Health Care Sci

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BackgroundInfusion sets designed for peristaltic finger smart pumps (PFSPs) are necessary for the pumps’ accurate handling. We previously found that medication dispensing is occasionally incomplete following the calculated infusion time when using certain combinations of PFSPs and infusion sets at a Japanese hospital. Thus, in this study, we investigated the cause of this observed delay by determining the effect of infusion set attachment technique on dispensing time using a combination of three kinds of PFSPs and five kinds of polyvinyl chloride (PVC) and polybutadiene (PB) infusion sets.MethodsPFSPs with their exclusive infusion sets were used. The PVC and PB infusion sets were either not stretched or stretched to 1–3 cm and attached to the PFSP’s liquid delivery system. PFSP dispensing rates were set at 25–400 mL/h. The primary outcome was the time required to dispense 100 mL of saline in a volumetric flask.ResultsThe complete dispensing time correlated with the input time for all equipment combinations when the infusion sets were not stretched before attachment to the PFSP (R2 = 0.9998–1.0000). When stretched, the complete dispensing time was longer than the input time (P < 0.01–0.05, analysis of variance with Tukey-Kramer multiple comparisons). The maximum dispensing time extension ratio for the PVC and PB infusion sets was 141.8% and 113.0%, respectively.ConclusionCertain attachment techniques for infusion sets can adversely prolong drug dispensing time. As such, pharmacists should provide medical staff with information about the devices used to administer drugs, as well as about the drugs themselves.

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Improving Infusion Pump Safety Through Usability Testing

Cited by 11 publications

References 12 publications

Risk of Medication Errors With Infusion Pumps

Risk of Medication Errors With Infusion Pumps

Usability of volumetric infusion pumps in pediatric intensive care

Influence of technique used to attach the infusion set to peristaltic finger smart-pumps on dispensing time: an experimental study

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