Safeguarding Patient Safety with Reliable Hospital IV Pumps

by Sara Alvarado

Updated January 23, 2024
The adoption of IV pumps in hospitals has increased tremendously in recent years. In the US, for example, more than 88% of hospitals had adopted smart infusion pumps by 2017, according to data from the ASHP (American Society of Health Systems Pharmacists).

This leap in hospital infusion pump usage reflects medical practitioners' intent to deliver medication and nutritional fluids to patients with greater precision and minimal margin of error.

However, because hospital IV pumps are human-made technology, they are prone to malfunctions. Besides, hospital infusion pumps are also human-run medical equipment, and their reliability can be compromised by user-related errors. Healthcare providers must adequately address these errors to prevent complications and adverse effects on patients.

To map the current status of hospital IV pump reliability, we explored infusion pump use in hospitals, their reliability, and the factors that compromise their safe use. We also identified practical strategies that governments, manufacturers, hospital management, and healthcare personnel can adopt to reduce these risk factors and enhance patient safety.
hospital iv pumps

1. IV Pump Use in Hospitals

The 1960s predecessors of today’s infusion pumps had a purely mechanical purpose: to simply deliver drugs intravenously.

Today, with the advancement of infusion pump technology and smart pump software, IV pump usage in hospitals is synonymous with precision and error reduction in drug and fluid infusion therapy.

Using IV pumps, clinicians and other hospital healthcare providers can access virtual drug libraries and use the intuitive infusion pump user interface to program drug dosage, flow rate, concentration, infusion mode, and delivery intervals.

They can also rely on inbuilt IV pump safety features for alerts or alarms in case of programming errors like over or under-dosage and pump dysfunction issues related to occlusion and battery life, among others.

In hospitals, infusion pumps are crucial medical equipment in both general and specialty areas, including:
Emergency rooms.
Intensive care units (ICU).
Oncology centers.
Surgery units.
Neonatal intensive care units.

2. Are Hospital IV Pumps Reliable?

hospital iv pumps
Hospital infusion pumps are deemed reliable if they can deliver medication and nutritional fluids accurately, without failure, and in the specified time and conditions.

Their reliability stays in the fact that they have:
Programming features such as virtual drug libraries and smart user interfaces that allow clinicians to feed precise patient and drug prescription details into the infusion system without manually calculating dosage and infusion rates.
Control features that alert clinicians when infusion therapy details or pump functioning is not as it should be. Models such as the Autoinfu alert you when there’s air in the tubing and to prevent titration errors.
While the reliability of infusion pumps has remained polemical over the years, many studies have proven that hospital IV pumps are reliable and effectively reduce dosage, flow rate, and other medication administration errors.

For example, a 2021 study found that IV pumps intercepted serious IV pump errors and averted adverse effects on patients. Overall, the use of infusion pumps reduced medication errors by 70%.

But, as earlier mentioned, the reliability of hospital infusion can be threatened by technology and user-based factors.

3. Factors Compromising Hospital IV Pump Reliability

hospital iv pumps
Accurate drug infusion is a matter of uncompromisable patient safety and, sometimes, a matter of life and death. This reiterates the fact that hospital infusion pumps must be accurate and reliable.

Unfortunately, past data suggests that hospital infusion pumps are responsible for a considerable percentage of medication errors, adverse drug events, and severe and life-threatening errors, up to over 50%.

Besides, IV drug infusion errors are more likely to cause adverse effects on patients compared to oral and other drug administration modes.

The reason?

Because IV infusions are delivered straight to the patient’s cardiovascular system and may not be reversed or neutralized.

For these reasons, any technology-based or human-based factors that threaten hospital IV pump accuracy and reliability should be prevented as much as possible.

So, which technology and human-based factors compromise hospital IV pump reliability?

Technology-based Factors

hospital iv pumps
These are related to IV pump hardware and software functioning and can also be due to IV pump wear and tear or outdated software. They include:
Manufacturing defects such as missing IV pump components, impending leaks, unresponsive keys, and system errors that are often the basis for infusion pump recalls.
Pump inaccuracy due to neglected preventative maintenance.
Broken or cracked IV pump parts due to wear and tear or poor pump handling, causing issues like leakage.
User interface designs that are not user-friendly because the language or instructions are unclear.
Failed alarm alerts, meaning the IV pump fails to activate the alarm during serious problems like occlusion or does not activate the alarm on time (Eg. A low battery only raises an alarm when the infusion pump is already turning off). The pump may also send a false alarm when there is no issue.
The labels on the IV pump user interface are erased by constant usage, creating a risk of wrong data entries.
Software errors such as “software is inoperable” without indicating the cause or ‘keyboard bounce’ when a single tap on a key is decoded as multiple taps, creating triple-digit entries when a two-digit entry is intended (Eg. 155mL/h instead of 15mL/h).
Electric failures where the IV pump returns a spark or shock when plugged into the outlet, posing a danger to healthcare providers and patients alike.

Human-based Factors

hospital iv pumps
These factors depend on how users interact with the IV pump when programming infusion therapies. They include:
Administering undocumented/unauthorized infusion therapies that cannot be accounted for.
Wrong use of drug libraries, like bypassing drug libraries when medication dosage or concentrations are not found, Also, using different drug measurement units if those on the order and in the drug library don’t match.
Programming and drug administration errors, including entering the wrong dosage, drug concentration and amount, flow rate, or patient weight, wrong administration mode, omitting drug administration, or infusing the wrong drug into the wrong patient.
IV pump support equipment errors such as the use of the wrong syringe size or wrong pump line, especially in multiple simultaneous infusions.
Forgetting to recharge low batteries while the battery alarm is on low volume and goes unnoticed, leading to infusion therapy interruption.
To counter these factors, hospital IV pump manufacturers and users should adopt strategies that enhance hospital IV pump reliability.

4. Strategies for Enhancing Hospital Infusion Pump Reliability

hospital iv pumps
Ensuring hospital IV pump reliability is a chain responsibility that involves governments, manufacturers, hospital management, healthcare providers, and other experts.

Each of these groups should play their part to ensure hospital infusion pumps are safe and reliable in the delivery of drugs and fluids to patients as follows:

Governments and Quality Assurance Agencies

Provide premarket guidelines to ensure manufacturers guarantee high rigor in the design and development stages of hospital infusion pumps. The FDA’s “White Paper: Infusion Pump Improvement Initiative” is a good example. It requires manufacturers to anticipate possible IV pump dysfunctions and address them before putting them on the market for use in hospitals.

Identify hospital IV pump recalls for equipment with manufacturer defects that pose significant risks of injury, temporary illness, or fatalities.

Manufacturers

Adhere to government guidelines on hospital infusion pump design and development and premarket assessments.

Promptly recall hospital IV pumps when possible design faults are identified.

Hospital management

Hire qualified labor and provide ongoing training for hospital personnel to be up-to-date with new hospital IV pump technologies and software. This will minimize programming and administration errors.

Monitor IV pump infusion using patient safety practices such as “double-checks” by a second independent clinician, especially when infusing high-risk medications.

Strictly follow IV pump preventative maintenance plans and use warranty servicing and repair plans. This should go hand in hand with having backup plans for prompt drug infusion delivery to patients should infusion pumps fail.
Follow manufacturer-recommended battery and IV pump lifespans for prompt replacements.

Healthcare providers
IV infusion pump 21
Follow hospital protocols on the use of infusion pumps.

Stay updated on hospital IV pump new technologies and software capabilities and limitations.

Report IV pump damage or dysfunction to the relevant bodies so they are addressed ASAP before using them again with patients.

Researchers and Experts
Consistently conduct studies on hospital IV pump reliability to provide up-to-date data, useful in reducing IV pump technology-related and human-related errors.

5. Quick Summary

Hospital IV pumps are indispensable equipment in any hospital today. Their primary purpose is to infuse drugs and fluids into patients’ circulatory systems with utmost accuracy and reliability.

Because they are human-made and human-run technology, experts often put into inquiry the reliability of hospital infusion pumps.

Generally, IV pumps are reliable hospital equipment. However, manufacturer and user-related errors can compromise their reliability.

Adhering to the set IV pump design and development guidelines among manufacturers and training hospital personnel in the safe use of IV pumps is crucial in enhancing IV pump reliability and patient safety.
Article by
Sara Alvarado
Greetings, I'm Sara, a dedicated nurse and a proud contributor to the AutoInfu blog. With my firsthand experience in the world of infusion pumps, I'm here to provide you with the latest insights, expert advice, and essential updates to ensure you stay informed about the infusion pump industry.

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