An Intervention to Increase Safety Feature Use on Smart Pumps: A Quality Improvement Initiative

Background: Medication errors due to intravenous administration are common. Metered infusion devices (MIDs) have reduced some administration errors, but the manual programming of these devices allows for continued risk. MIDs with safety features, smart pumps, have been shown to reduce intravenous medication errors, but usage rate of the safety features is reported to be low. Objective: To identify obstacles to the use of the smart pump safety feature and investigate the effectiveness of educational interventions to address these obstacles and improve safety feature use rates. Methods: This cross-sectional study was designed for quality improvement. A 10-question paper survey targeting potential obstacles was distributed to parttime and full-time nurses on the cardiovascular service of an academic hospital to ascertain the limitations to using the safety feature technology. Based on survey results, educational interventions were developed, which included a required educational active-learning, practical session, and optional didactic presentation. The primary end point was change in the rate of use during a prespecified month before (July 2010) and after (April 2011) targeted interventions. Descriptive analysis was performed on survey results. Student t test and chi(2) analyses were used to compare usage rates. Results: Surveys were distributed to 60 nurses; 36 were returned and 1 was excluded, leaving 35 in the final analysis. Primary obstacles to using the safety features identified were education/training, technology burden, and drug library accuracy/content. After educational training sessions, usage rates of the smart pump safety feature increased significantly, 5.5 times from baseline (5.5% vs 30.5%; p < 0.001). Conclusions: Targeting education and providing hands-on training directed to nurses' perceived barriers to use of smart pumps was an effective method to improve use of safety features, although overall utilization can be improved.