Abstract
“Smart” infusion pumps include built in drug error reduction software which uses a drug library. Studies have reported the drug library build should be undertaken by a multidisciplinary team, including a pharmacist; however, the extent or nature of the input required by the pharmacist for greatest benefit is unknown. This review aimed to identify key factors for the implementation of the smart infusion pumps, with a focus on the role of pharmacists and compare this to the experience from a case study. A literature review was conducted using Embase and Ovid Medline, and 13 eligible papers were found. Predominant themes relating to the pharmacist’s role and successful implementation of the smart infusion pumps were determined. Key factors for success included team involvement across the entire process from procurement, set-up through to implementation including risk assessment and device distribution, and training, which were comparable to the case study experience. Few studies described the extent or details of the pharmacist’s responsibilities.
Highlights
The National Patient Safety Agency (NPSA) in England identified that incidents involving injectable medicines represented 62% of all reported incidents leading to death or severe harm [1]
All the included articles involved pharmacists in the development of the drug library (Table 1); nine involved nursing staff and ten had at least one physician involved with the development of the drug library
The limited literature and our experience shows that involvement of a multidisciplinary group, including pharmacists, is essential from the purchasing process through to implementation to facilitate a clear strategy for drug library build and subsequent adoption and use
Summary
The National Patient Safety Agency (NPSA) in England identified that incidents involving injectable medicines represented 62% of all reported incidents leading to death or severe harm [1].Observational studies conducted at multiple hospitals within the United Kingdom (UK) and the UnitedStates (US) have reported error rates of up to approximately 60% [2,3], with recent studies reporting that only up to 1.1% of all the discrepancies and infusion errors witnessed were potentially harmful, and none would have prolonged hospital stay or resulted in long term harm [2,4].Infusion pumps that control the administration of medication infusions at a set rate were introduced worldwide over 40 years ago. Observational studies conducted at multiple hospitals within the United Kingdom (UK) and the United. States (US) have reported error rates of up to approximately 60% [2,3], with recent studies reporting that only up to 1.1% of all the discrepancies and infusion errors witnessed were potentially harmful, and none would have prolonged hospital stay or resulted in long term harm [2,4]. Infusion pumps that control the administration of medication infusions at a set rate were introduced worldwide over 40 years ago. These have evolved vastly over time from manual control into sophisticated automated systems with in-built safety features and ability to interface with other electronic systems [5]. DERS is considered a safety feature as it has the capacity to have pre-set limits for specific medications, thereby preventing unsafe infusion rates or errors in dose calculation [5]
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