System-Level Patient Safety Practices That Aim to Reduce Medication Errors Associated With Infusion Pumps: An Evidence Review

Abstract

Objectives In this literature review, we discuss 2 system-level, nurse-targeted patient safety practices (PSPs) that aim to reduce medication errors associated with infusion pumps, including smart pumps. One practice focuses on implementing structured process changes and redesigning workflows to improve efficiencies with pump use. The other focuses on investing in initial and ongoing staff training on the correct use, maintenance, and monitoring of infusion pumps. Methods Two databases were searched for “infusion pumps” and related synonyms, along with relevant terms for each PSP. Articles were excluded if outcomes were not directly relevant to the PSP addressed in this review, the article was out of scope, or study design was insufficiently described. Results Limited research was found on best practices for reducing errors and improving infusion pump use through workflow and process changes, as well as education and training. Four studies reported medication administration errors, procedural errors, or deviations from hospital policy as clinical outcomes of workflow or process changes. Mixed results were found examining process outcomes related to pump handling. Education on the correct use of smart pumps was found to decrease medication errors and adverse drug events, and 2 studies found an increase in nurses’ adherence to using the medication safety software library as a result of education. Conclusions Standardization of process and integration of technology and workflows were found as facilitators. Type and content of education provided were identified as facilitators, whereas time and energy constraints on nurse educators can be barriers to implementing large hospital-wide education programs.

A National Survey of Secondary Traumatic Stress and Work Productivity of Emergency Nurses Following Trauma Patient Care

“…System designs such as bar coding and teamwork can prevent negative work productivity even in the presence of secondary traumatic stress. Additional system designs developed for patient safety include performing time-outs (Hazelton et al, 2015), matching patient identification bracelets to blood products (Booth, Allard, & Robinson, 2021), and use of smart intravenous pumps (Bacon & Hoffman, 2020). Although system designs are necessary to address patient safety, additional interventions that promote resilience are warranted for the overall well-being of emergency nurses.…”

Experience of Nurses with Intravenous Fluid Monitoring for Patient Safety: A Qualitative Descriptive Study

“…However, only a few studies have identified the causes of IV fluid MAEs focusing on infusion pump-related errors. [9][10][11] Previous studies also have limitations in comprehensively understanding the causes or risk factors contributing to IV fluid infusion MAEs because most studies used self-reported questionnaires to examine the incidence and causes of general IV MAEs. According to the survey study conducted in Iran, 12 the most common IV MAEs included wrong medication (27.1%) followed by wrong dose (17.9%) and wrong infusion rate (17.2%).…”

Percepciones de los estudiantes de enfermería sobre la administración segura de medicamentos

“…Ha habido iniciativas para educar a las futuras enfermeras sobre la seguridad. Algunos apoyan el cambio del diseño del trabajo y el uso de tecnologías de la información destinadas a reducir errores, como códigos de barras o bombas inteligentes (6,7) . Otras estrategias utilizadas optan por mejorar los conocimientos, habilidades y actitudes de los profesionales de la salud en el proceso de administración (8,9) .…”