scholarly journals Nurse and Pharmacist Knowledge of Intravenous Smart Pump System Setup Requirements

2021 ◽  
Vol 55 (1) ◽  
pp. 51-58
Author(s):  
Karen K. Giuliano ◽  
Jeannine W.C. Blake
Keyword(s):  
Response Rate ◽  
Infusion Pump ◽  
Secondary Analysis ◽  
Direct Care ◽  
Innovative Technology ◽  
Pump System ◽  
Final Sample ◽  
Infusion Systems ◽  
Head Height ◽  
Smart Pump

Abstract Objective: The primary purpose of this research was to describe nurse and pharmacist knowledge of setup requirements for intravenous (IV) smart pumps that require head height differentials for accurate fluid flow. Methods: A secondary analysis of anonymous electronic survey data using a database of prerecruited clinicians was conducted. A survey was sent by email to 173 pharmacists and 960 nurses. The response rate for pharmacists was 58% (100 of 173), and the response rate for nurses was 52% (500 of 960). After removing respondents who did not provide direct care and who did not use a head height differential IV infusion system, the final sample for analysis was 186 nurses and 25 pharmacists. Results: Overall, less than one-half of respondents (40%) were aware that manufacturer guidelines for positioning the primary infusion bag relative to the infusion pump were available. Slightly more (49.5%) were aware of the required head height differentials for secondary infusion. Only five respondents selected the correct primary head height, eight respondents selected the correct secondary head height, and one respondent selected both the correct primary and secondary head heights. Conclusion: The results of this study identify a substantial lack of knowledge among frontline clinicians regarding manufacturer recommendations for accurate IV administration of primary and secondary infusions for head height differential infusion systems. Both increased clinician education and innovative technology solutions are needed to improve IV smart pump safety and usability.

scholarly journals Integrating and Evaluating the Data Quality and Utility of Smart Pump Information in Detecting Medication Administration Errors: Evaluation Study (Preprint)

2020 ◽  
Author(s):  
Yizhao Ni ◽  
Todd Lingren ◽  
Hannah Huth ◽  
Kristen Timmons ◽  
Krisin Melton ◽  
...  
Keyword(s):  
Data Quality ◽  
Error Detection ◽  
Clinical Setting ◽  
Infusion Pump ◽  
Medication Use ◽  
Primary Source ◽  
Evaluation Study ◽  
Medication Administration ◽  
Medication Administration Errors ◽  
Smart Pump

BACKGROUND At present, electronic health records (EHRs) are the central focus of clinical informatics given their role as the primary source of clinical data. Despite their granularity, the EHR data heavily rely on manual input and are prone to human errors. Many other sources of data exist in the clinical setting, including digital medical devices such as smart infusion pumps. When incorporated with prescribing data from EHRs, smart pump records (SPRs) are capable of shedding light on actions that take place during the medication use process. However, harmoniz-ing the 2 sources is hindered by multiple technical challenges, and the data quality and utility of SPRs have not been fully realized. OBJECTIVE This study aims to evaluate the quality and utility of SPRs incorporated with EHR data in detecting medication administration errors. Our overarching hypothesis is that SPRs would contribute unique information in the med-ication use process, enabling more comprehensive detection of discrepancies and potential errors in medication administration. METHODS We evaluated the medication use process of 9 high-risk medications for patients admitted to the neonatal inten-sive care unit during a 1-year period. An automated algorithm was developed to align SPRs with their medica-tion orders in the EHRs using patient ID, medication name, and timestamp. The aligned data were manually re-viewed by a clinical research coordinator and 2 pediatric physicians to identify discrepancies in medication ad-ministration. The data quality of SPRs was assessed with the proportion of information that was linked to valid EHR orders. To evaluate their utility, we compared the frequency and severity of discrepancies captured by the SPR and EHR data, respectively. A novel concordance assessment was also developed to understand the detec-tion power and capabilities of SPR and EHR data. RESULTS Approximately 70% of the SPRs contained valid patient IDs and medication names, making them feasible for data integration. After combining the 2 sources, the investigative team reviewed 2307 medication orders with 10,575 medication administration records (MARs) and 23,397 SPRs. A total of 321 MAR and 682 SPR dis-crepancies were identified, with vasopressors showing the highest discrepancy rates, followed by narcotics and total parenteral nutrition. Compared with EHR MARs, substantial dosing discrepancies were more commonly detectable using the SPRs. The concordance analysis showed little overlap between MAR and SPR discrepan-cies, with most discrepancies captured by the SPR data. CONCLUSIONS We integrated smart infusion pump information with EHR data to analyze the most error-prone phases of the medication lifecycle. The findings suggested that SPRs could be a more reliable data source for medication error detection. Ultimately, it is imperative to integrate SPR information with EHR data to fully detect and mitigate medication administration errors in the clinical setting.

Smart Pump App for Infusion Pump Training

2018 ◽  
Vol 17 ◽  
pp. 28-37 ◽  
Author(s):  
Erin Quattromani ◽  
Margaret Hassler ◽  
Nikki Rogers ◽  
Jennifer Fitzgerald ◽  
Paula Buchanan
Keyword(s):  
Infusion Pump ◽  
Smart Pump

scholarly journals Eptacog Alfa (Activated) Is Physically and Chemically Stable over 24 Hours when Administered as Bolus Injections in an Automated Infusion Pump

TH Open ◽  
2019 ◽  
Vol 03 (01) ◽  
pp. e45-e49 ◽  
Author(s):  
Per Rexen ◽  
Jane Jensen ◽  
Nina Schwerin ◽  
Elena Kozina
Keyword(s):  
Bolus Injection ◽  
Infusion Pump ◽  
Hospital Setting ◽  
Factor Vii ◽  
Acceptance Criteria ◽  
Recombinant Activated Factor Vii ◽  
Pump System ◽  
Promising Alternative ◽  
Bolus Infusion

Introduction Eptacog alfa (activated) is a recombinant activated factor VII (rFVIIa) used for the treatment and prevention of bleeding episodes in patients with congenital hemophilia with inhibitors. Frequent dosing requirements make the use of an automated bolus infusion pump a promising alternative to manual administration. Aims The objective of this in vitro study was to evaluate the physical and chemical stability of room temperature–stable rFVIIa at 25°C over 24 hours in an automated bolus infusion pump. Methods An automated bolus infusion pump with preset bolus injection intervals of 2 to 6 hours was used. Samples of rFVIIa were analyzed for critical quality parameters, presence of leachables, and microbiological growth. The infusion system was evaluated visually. Results rFVIIa is physically and chemically stable when used in an automated bolus infusion pump system for up to 24 hours at 25°C. All critical quality parameter results were within the shelf-life limits and complied with the acceptance criteria. Leachables were observed at concentrations within their respective acceptance criteria. No visual changes in the syringe or infusion tube were observed; inherent particles in the reconstituted rFVIIa similar in size and description to those previously found in rFVIIa were seen. No microbiological growth was detected. Conclusions rFVIIa is stable in a bolus infusion pump system for up to 24 hours at 25°C. Bolus injection intervals of 2 to 6 hours can be used without physical or chemical changes to rFVIIa. This study supports the use of an automated bolus infusion pump in the hospital setting, across all indications for rFVIIa.

Spinal infusion pump-catheter leak detected by high-resolution 3D computed tomography

2011 ◽  
Vol 15 (5) ◽  
pp. 555-557 ◽  
Author(s):  
Jason A. Ellis ◽  
Richard Leung ◽  
Christopher J. Winfree
Keyword(s):  
High Resolution ◽  
Contrast Medium ◽  
Infusion Pump ◽  
Post Injection ◽  
3D Ct ◽  
Intrathecal Catheter ◽  
Pump System ◽  
Plain Radiographs ◽  
Iodinated Contrast ◽  
Catheter System

Implanted intrathecal drug delivery systems may malfunction as a result of fracture of the intrathecal catheter. A suspected catheter fracture not seen on plain radiographs of the catheter system will typically prompt a contrast-enhanced imaging study of the pump. Injection of iodinated contrast medium into the pump system with routine fluoroscopy can sometimes fail to reveal subtle leaks. The authors present a case demonstrating the utility of high-resolution, 3D-CT for intrathecal pump-catheter system interrogation when routine fluoroscopy is unrevealing. In this case, a catheter leak was suspected on the basis of the patient's history, but no obvious fracture was noted on plain radiographs. An intraoperative fluoroscopic study that included multiple injections of contrast medium into the catheter system failed to conclusively show a catheter leak. The authors therefore performed a post-injection 3D-CT study, which clearly demonstrated a leak from the intrathecal catheter just deep to the thoracolumbar fascia. The leak was visible on source images and was especially obvious after 3D reconstruction. This led to surgical revision of the catheter and subsequent resumption of normal pump function. The authors therefore suggest that if a leak is suspected in an implanted intrathecal catheter and routine contrast fluoroscopy is unrevealing, post-injection 3D-CT scanning should be performed to further investigate the possibility of a subtle leak.

Impact of interoperability of smart infusion pumps and an electronic medical record in critical care

2020 ◽  
Vol 77 (15) ◽  
pp. 1231-1236
Author(s):  
Roy Joseph ◽  
Sang Weon Lee ◽  
Scott V Anderson ◽  
Matthew J Morrisette
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Infusion Pump ◽  
Medication Administration ◽  
Absolute Difference ◽  
Infusion Pumps ◽  
Adult Intensive Care Unit ◽  
Incremental Value ◽  
The Impact ◽  
Smart Pump

Abstract Purpose To describe the benefits of smart infusion pump interoperability with an electronic medical record (EMR) system in an adult intensive care unit (ICU) setting. Summary In order to assess the impact of smart infusion pump and EMR interoperability, we observed whether there were changes in the frequency of electronic medication administration record (eMAR) documentation of dose titrations in epinephrine and norepinephrine infusions in the ICU setting. As a secondary endpoint, we examined whether smart pump/EMR interoperability had any impact on the rate of alerts triggered by the dose-error reduction software. Pharmacist satisfaction was measured to determine the impact of smart pump/EMR interoperability on pharmacist workflow. In the preimplementation phase, there were a total of 2,503 administrations of epinephrine and norepinephrine; 13,299 rate changes were documented, for an average of 5.31 documented rate changes per administration. With smart pump interoperability, a total of 13,024 rate changes were documented in association with 1,401 administrations, for an average of 9.29 documented rate changes per administration (a 74.9% increase). A total of 1,526 dose alerts were triggered in association with 76,145 infusions in the preimplementation phase; there were 820 dose alerts associated with 48,758 autoprogammed infusions in the postimplementation phase (absolute difference, –0.32%). ICU pharmacists largely agreed (75% of survey respondents) that the technology provided incremental value in providing patient care. Conclusion Interoperability between the smart pump and EMR systems proved beneficial in the administration and monitoring of continuous infusions in the ICU setting. Additionally, ICU pharmacists may be positively impacted by improved clinical data accuracy and operational efficiency.

Factors Affecting the Costs of UK VAT Compliance for Small and Medium-Sized Enterprises

10.1068/c0319 ◽  
2003 ◽  
Vol 21 (4) ◽  
pp. 479-492 ◽  
Author(s):  
Ann Hansford ◽  
John Hasseldine ◽  
Carole Howorth
Keyword(s):  
Response Rate ◽  
First Language ◽  
Value Added ◽  
Regulatory Requirements ◽  
Government Regulations ◽  
Compliance Costs ◽  
Factors Affecting ◽  
The United Kingdom ◽  
Final Sample ◽  
Total Compliance

As firms grow, taxation and, in particular, value added tax (VAT), is one of the first areas in which they must deal with government regulations. It has been argued in the United Kingdom that regulatory requirements are burdensome and can even be a constraint on the development and growth of small and medium-sized enterprises (SMEs). The authors focus on SMEs and link the literature on VAT regulations and compliance costs to wider issues relating to SMEs. The costs of complying with VAT regulations are separated into core costs and total costs. Core costs are the mandatory costs that SMEs have to incur in order to comply with the VAT legislation and regulations. Total costs include VAT planning and one-off costs. For SMEs core costs represent a larger proportion of total compliance costs than is the case for larger businesses. A reduction in core costs would have a significant impact on the total VAT-compliance costs for SMEs. Factors expected to be associated with higher compliance costs are identified and tested in a multivariate framework. Empirical data were obtained from a survey of 4796 firms resulting in a final sample of 1085 firms and a response rate of 25.1%. Higher compliance costs (in absolute terms) are associated, inter alia, with increased turnover, newly registered firms, and increased complexity. Firms with higher compliance costs also perceived high psychological costs of VAT compliance. Compliance costs were also higher for individuals who did not have English as their first language, and individuals with special needs. The important implications of the findings for policy are highlighted.

B411 Development of Portable Infusion Pump System

2008 ◽  
Vol 2008.19 (0) ◽  
pp. 151-152
Author(s):  
Yusuke MUKASA ◽  
Hiroyuki KOYAMA ◽  
Takashi KOMEDA ◽  
Atsushi SEKIGUCHI ◽  
Takashi MORITA
Keyword(s):  
Infusion Pump ◽  
Pump System

scholarly journals Efficacy of Telavancin in the Treatment of Experimental Endocarditis Due to Glycopeptide-Intermediate Staphylococcus aureus

2007 ◽  
Vol 51 (7) ◽  
pp. 2373-2377 ◽  
Author(s):  
José M. Miró ◽  
Cristina García-de-la-Mària ◽  
Yolanda Armero ◽  
Elisa de-Lazzari ◽  
Dolors Soy ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Statistical Significance ◽  
Infusion Pump ◽  
Treated Group ◽  
Control Group ◽  
Pump System ◽  
Once Daily ◽  
End Of Treatment ◽  
Computer Controlled ◽  
Trough Levels

ABSTRACT The efficacy of telavancin, a novel lipoglycopeptide, was evaluated in experimental endocarditis in rabbits using two clinical isolates of glycopeptide-intermediate Staphylococcus aureus: ATCC 700788 and HIP 5836. Infected rabbits were treated for 2 days with telavancin (10 mg/kg of body weight once daily intravenously) or vancomycin (1 g twice daily intravenously), administered with a computer-controlled infusion pump system simulating human serum kinetics. Vegetations were harvested at 16 h postinoculation in the control group and at the end of treatment in the drug-treated group. For ATCC 700788, MICs and minimal bactericidal concentrations (MBCs), respectively, were 1 mg/liter and 4 mg/liter for telavancin and 8 mg/liter and 128 mg/liter for vancomycin. For HIP 5836, MICs and MBCs, respectively, were 4 mg/liter and 8 mg/liter for telavancin and 8 mg/liter and 128 mg/liter for vancomycin. Peak and trough levels were 90 μg/ml and 6 μg/ml, respectively, for telavancin and 46 μg/ml and 6 μg/ml, respectively, for vancomycin. In glycopeptide-intermediate S. aureus ATCC 700788, telavancin sterilized 6 of 16 vegetations (37%), whereas vancomycin sterilized 4 of 20 (20%) (P = 0.29) compared with 0 of 17 in the control group. In HIP 5836 experiments, telavancin and vancomycin sterilized 5 of 16 (31%) and 1 of 15 (7%) vegetations (P = 0.17), respectively, compared with none in the control group. Telavancin reduced vegetation titers by 2.0 and 2.3 logs greater than vancomycin for the ATCC 700788 (4.6 [2.0 to 5.8] versus 6.6 [2.0 to 6.9] log CFU/g vegetation; P = 0.05) and HIP 5836 (4.4 [2.0 to 7.4] versus 6.7 [4.5 to 8.7] log CFU/g vegetation; P = 0.09) strains, respectively; these differences did not reach statistical significance. All isolates from vegetations remained susceptible to telavancin after therapy. The results suggest that telavancin may be an effective treatment for endocarditis caused by glycopeptide-intermediate S. aureus.

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