Why is the development of infusion pumps important

Infusion pumps are in widespread use in clinical settings such as hospitals, and in the home. In general, an infusion pump is operated by a trained user, who programs the rate and duration of fluid delivery through a built-in software interface.

Infusion pumps offer significant advantages over manual administration of fluids, including the ability to deliver fluids in very small volumes, and the ability to deliver fluids at precisely programmed rates or automated intervals.

There are many different types of infusion pumps, which are used for a variety of purposes and in a variety of environments. Infusion pumps may be capable of administering fluids in large or small volumes, and may be used to deliver nutrients or medications, such as insulin or other hormones, antibiotics, chemotherapy drugs, and pain relievers. Others, called ambulatory infusion pumps, are designed to be portable or wearable. There are a number of commonly used specialty infusion pumps, including enteral , patient-controlled analgesia PCA , and insulin infusion pumps.

PCA infusion pumps are used to deliver pain medication, and are equipped with a feature that allows patients to self-administer a controlled amount of medication, as needed.

Insulin infusion pumps are typically used to deliver insulin to patients with diabetes, and are frequently used in the home. Different types of infusion pumps have different fluid-control mechanisms, which may be powered electrically or mechanically. In a syringe infusion pump, for example, fluid is held in the reservoir of a syringe, and a moveable piston controls fluid delivery. In an elastomeric infusion pump, fluid is held in a stretchable balloon reservoir, and pressure from the elastic walls of the balloon drives fluid delivery.

In a peristaltic pump, a set of rollers pinches down on a length of flexible tubing, pushing fluid forward. Some complex infusion pumps are capable of delivering fluids from multiple reservoirs at multiple rates. Because infusion pumps are frequently used to administer critical fluids, including high-risk medications, pump failures can have significant implications for patient safety. Many infusion pumps are equipped with safety features, such as alarms or other operator alerts that are intended to activate in the event of a problem.

For example, some pumps are designed to alert users when air or another blockage is detected in the tubing that delivers fluid to the patient. From through , FDA received approximately 56, reports of adverse events associated with the use of infusion pumps, including numerous injuries and deaths.

During this time period, 87 infusion pump recalls were conducted by firms to address identified safety concerns. Backpressure in the tubing remains an important factor affecting flow rate.

To compensate for this, adaptive pump technology must include a means to measure the actual fluid output from the system. Existing peristaltic LVPs rely on pre-determined position or speed measurements of the various pumping elements. If, for example, a motor is turning at the proper speed, the system assumes that flow output is as desired. However, in reality, external conditions also influence the fluid path.

For example, the motor might be moving correctly, but an increase in downward head pressure from the medication container may alter the fluid volume in the tubing. Currently, the impact of this is not measured and compensated for by infusion system software.

By contrast, a pneumatically-driven, adaptive pumping technology enables direct measurement of volumetric changes right at the point where fluid exits the pump and enters the patient. This direct flow measurement allows adjustment of the LVP through its control software to maintain target flow rates as external conditions change. Now, while an increase in backpressure might decrease flow, the system recognizes this and makes adjustments to bring the rate back to the target.

The combination of a smooth profile and an adaptive measurement and control system ensures that the pump is delivering what the clinician intended, regardless of system dynamics and external factors. New test and disclosure standards focusing on accuracy and flow continuity are underway. But, more importantly, a new paradigm for fluid delivery is necessary. It must enable LVPs to adapt to external conditions while delivering fluids continuously and accurately.

American College of Obstetricians and Gynecologists. Obstet Gynecol , , 7. Baranowski, L. Presidential address: take ownership. J Intraven Nurs , 18 , —4. IEC , October IEC What Is an Infusion Pump? Weinger, M. Reflections on the Current State of Infusion Therapy.

Biomed Instrum Technol. Startup and trumpet curves showing computed pump performance data are illustrated in Figure 1. Flow Characteristics in the Clinical Environment In a real-world environment, various environmental factors may dramatically affect flow rates.

The Potential Impact to Patient Safety Approximately nine out of 10 hospitalized patients receive intravenous infusions Baranowski, There are many types of infusion pumps, including large volume, patient-controlled analgesia PCA , elastomeric, syringe, enteral, and insulin pumps,. Others, called ambulatory infusion pumps, are designed to be portable or wearable. Because infusion pumps are frequently used to administer critical fluids, including high-risk medications, pump failures can have significant implications for patient safety.

Many infusion pumps are equipped with safety features, such as alarms or other operator alerts that are intended to activate in the event of a problem. For example, some pumps are designed to alert users when air or another blockage is detected in the tubing that delivers fluid to the patient.

Infusion therapy standards of practice, 8th edition. J Infus Nurs. Institute for Safe Medication Practices. February 10, Clinical practice guideline: Safe medication use in the ICU.

Crit Care Med. The effectiveness of interventions designed to reduce medication administration error: A synthesis of findings from systematic reviews. J Nurs Manag. A multi-hospital before-after observational study using a point-prevalence approach with an infusion safety intervention bundle to reduce intravenous medication administration errors.

The Joint Commission. April 14, Food and Drug Administration. Infusion pump risk reduction strategies for facility administrators and managers. February 2, Syringe pump problems with fluid flow continuity at low infusion rates can result in serious clinical consequences: FDA safety communication.

August 25, Best practices to decrease infusion-associated medication errors. Save my name, email, and website in this browser for the next time I comment. Powered by www. No part of this website or publication may be reproduced, stored, or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the copyright holder.

American Nurse American Nurse. Sign in. Forgot your password? Get help. Create an account. Password recovery. Home Clinical Topics Smart pumps, smart management, safe patients. Smart pumps, smart management, safe patients. May 6, When organizations and clinicians team up, patients are protected. Takeaways: Medication administration errors continue to occur due to mistakes in smart electronic infusion pump setup, programming, and clinical management.

Patients suffer the consequences of medication errors associated with smart infusion pumps, resulting in therapeutic regimen disruption, loss of therapeutic effect, debilitating injury, or even death.

Healthcare organizations must design infrastructures—through smart infusion system procurement, implementation, application, maintenance, and continuous quality improvement—that support patient safety.

Bi-directional benefits and challenges Bi-directional smart infusion pumps raise the standard of care but also present some challenges. Challenges Bi-directional smart infusion pumps can be cost-prohibitive are available only with select infusion pump brands rely on a sound wireless infrastructure.

Organizational responsibilities Organizations must be fully engaged in developing infrastructure that leads and supports safe smart infusion pump use. Choose appropriate smart infusion pumps Use smart infusion pumps for therapies that require precise flow-control for safe administration.

Pump selection Base selection on the prescribed infusion therapy, rate control requirements, infusion-related risks, patient care setting, and available organizational resources.

Standardize the types of pumps used to promote user familiarity.