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Smart Pumps

In the realm of intravenously administered medications, a decimal-point error can represent an enormous, and potentially fatal, departure from the correct dosage. The magnitude of this patient safety hazard is even more daunting when one considers that two-thirds of medication errors involve injectable medications and that over half of the most severe preventable drug alerts are IV related. Smart infusion pumps are designed to add a line of defense at the bedside against such medication errors by ensuring that the right medication and dose go to the right patient every time.

While all vendors claim to significantly increase patient safety, are they able to deliver on that promise? What distinctions, if any, exist among the vendors and their offerings? What are the hurdles in product adoption and nurse compliance? What advancements in smart pump technology is the market demanding?

KLAS interviewed over 200 healthcare professionals regarding the experiences they are having with their smart infusion pump vendors and products to find out the answers to these and other questions. This study focuses on large volumetric pumps (LVPs) with dose calculation software. Additional data on syringe and patient-controlled analgesia (PCA) pumps is also included in this report.

To date, wireless technology has been the greatest advancement in smart infusion pump technology, but wireless medication orders from the pharmacy to a smart pump are not taking place yet with any commercially available pump. KLAS did interview one organization that has interfaced medication orders arriving at the pump, real-time monitoring of infusions, and full integration with their EMR; however, this software system was homegrown and not commercially available.

While almost all providers indicated that IV closed-loop medication administration is not yet a reality, there is little consensus as to how this should be accomplished. Some doubt whether the pharmacy sending orders to a pump, even with nurse validation, would actually be safer as it could leave the door wide open to different errors. Some organizations see barcoding as the best possible solution for ensuring IV pump safety.

Barcoding is being implemented with Hospira’s LifeCare (PCA) pump, in some cases the B. Braun Outlook Pump, and Cardinal Health’s Auto-ID feature for the Alaris pump. Though most organizations do not have this capability yet, many providers consider the addition of barcoding functionality to the infusion pumps as an important step to preventing medication errors.

This year’s study focus is on large volumetric smart infusion pumps. Additionally, data is included regarding patient-controlled analgesia smart pumps and syringe smart pumps. Vendors and products included in the main body of this research had a smart pump solution validated in at least 15 unique organizations. Vendors in the early data section had solutions in at least 6 organizations.

The table below details the vendors and products included in this report.

The vendors in this research all originated outside of healthcare IT, entering the smart infusion pump market via their presence in the markets for pharmaceuticals and medication delivery devices. Providers interviewed for this study believe that though these vendors have a sound understanding of patient safety issues, there is room for improvement in terms of providing the functionality and support necessary to fully integrate these pumps into a client organization’s strategy for IT-driven medication administration.

Patient safety is the overarching reason for the existence of smart pump technology, and the most important driver for patient safety is the functionality of the pump itself. Functionality, particularly ease of use of the pump, was the number one reason why a particular vendor’s offering was selected in a purchase decision. Functionality has a direct impact on nurse compliance in using the product with dose limits in place, thus functionality equates to a certain level of patient safety.

Marla Husch, RPh, from Central DuPage Hospital in Winfield, Illinois, observed, "When an infusion pump can provide a warning that penicillin is about to be administered to a patient with a known penicillin allergy or Baby A is about to receive Baby B’s heparin, the level of medication safety that our patients and nurses deserve will be closer at hand."

LVP products qualifying to be included in the 2008 Smart Pump research are B. Braun Outlook, Baxter Colleague, Cardinal Health Alaris System (LVP), Hospira Plum A+/MedNet, and Sigma Spectrum. Early findings were also included for Hospira Symbiq.

PCA products qualifying to be included in the 2008 Smart Pump research are Cardinal Health Alaris System (PCA) and Hospira LifeCare. Early findings were also included for B. Braun Curlin and Smiths CADD.

Syringe products qualifying to be included in the 2008 Smart Pump research are Cardinal Health Alaris System (Syringe) and Smiths Medfusion .

Vendor Performance Research Tools:

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• Access sample report, read more about the 2008 Smart Pumps research, or purchase the report

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