Published in:
Open Access 01-01-2008 | Original Article
Programmable Infusion Pumps in ICUs: An Analysis of Corresponding Adverse Drug Events
Published in: Journal of General Internal Medicine | Special Issue 1/2008
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Background
Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable.
Objectives
To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software (“smart pump”) and to suggest potential improvements in smart-pump design.
Design
Using retrospective medical-record review, we examined preventable IV-ADEs in ICUs before and after 2 hospitals replaced conventional pumps with smart pumps. The smart pumps alerted users when programmed to deliver duplicate infusions or continuous-infusion doses outside hospital-defined ranges.
Participants
4,604 critically ill adults at 1 academic and 1 nonacademic hospital.
Measurements
Preventable IV-ADEs matching smart-pump features and errors involved in preventable IV-ADEs.
Results
Of 100 preventable IV-ADEs identified, 4 involved errors matching smart-pump features. Two occurred before and 2 after smart-pump implementation. Overall, 29% of preventable IV-ADEs involved overdoses; 37%, failures to monitor for potential problems; and 45%, failures to intervene when problems appeared. Error descriptions suggested that expanding smart pumps’ capabilities might enable them to prevent more IV-ADEs.
Conclusion
The smart pumps we evaluated are unlikely to reduce preventable IV-ADEs in ICUs because they address only 4% of them. Expanding smart-pump capabilities might prevent more IV-ADEs.