Infusion pumps are used to push fluids, medications, and/or nutrients into a patient for therapeutic purposes. At their simplest, infusion pumps consist of a user interface that controls an electromechanical pumping mechanism responsible for pushing fluid from the fluid container (e.g., bag, syringe, bottle) through a length of flexible tubing called an administration set (which is often proprietary) into a patient’s catheter. They are most commonly used for IV administrations, although subcutaneous, arterial, intrathecal, and epidural infusions are frequently employed.
Infusion pumps are used in hospitals, in alternative care settings (e.g., physicians’ offices, outpatient infusion centers), and, occasionally, in emergency medical service vehicles. In general, infusion pumps are used when the solution to be administered must be delivered with greater accuracy or speed than can be provided through a manually adjusted gravity administration set. Because of their accuracy, infusion pumps have proven to be useful in applications such as continuous epidural anesthesia, administration of IV cardiovascular drugs, chemotherapy, and pediatric applications, as well as for home IV therapy.
The basic mechanical performance of all of these devices has changed very little in recent years. However, that doesn’t mean the technology itself hasn’t evolved, and advances in computing power and an increasing awareness of medication safety have resulted in significant changes in the way infusion pumps are purchased, implemented, and used.
So when it comes to selection and purchasing, hospitals are concentrating on a host of other issues rather than focusing strongly on mechanical performance. For example: How easy is the pump to use? How well does the system’s dose error reduction system (DERS) function? How extensive and configurable is the pump’s drug library? How well does the pump communicate with the pump server—and how easy is it to integrate the pump with other hospital systems, either now or in the future? What kind of tools are provided to help analyze log data?
Here are the fundamentals about infusion technology and the issues that surround it.
Understanding the Technology
There are the four main types of infusion pumps, each designed to address different care practices. Learn about their features, functions, and capabilities.
Large-Volume Infusion Pumps
Also known as general-purpose pumps, large-volume pumps deliver fluids from bags or bottles.
Syringe Infusion Pumps
Syringe pumps use a motor to depress the plunger on a syringe that injects fluid into the patient.
Patient-controlled analgesic pumps allow the patient to activate the delivery of pain medication within predetermined limits; the pump controls and drug reservoir are usually in a lockbox to prevent tampering by unauthorized personnel.
Ambulatory Infusion Pumps
These pumps are worn or carried by patients who require infusion support while moving about; the drug reservoir is often a small internal container.
Selection and Purchasing
As with many devices, purchasing infusion pumps is much more complicated than it used to be. Infusion system purchases today involve buying a complete drug delivery platform, including pumps, software, and communication interfaces. In addition, if you plan to utilize wireless networking capabilities on your infusion pumps, you must ensure that the hospital network is equipped to provide reliable wireless communication everywhere a pump will be. Finally, to experience the safety benefits of dose error reduction systems (DERS), a large commitment to drug standardization and drug library development is required.
Buying a pump involves establishing a long-term relationship with the pump’s supplier, on whom you’ll have to rely heavily for initial implementation, product upgrades, and ongoing support. The barrier to switching suppliers once you’ve already implemented a smart pump model is also much higher than with traditional pumps: If you’re going to switch, you will probably have to make changes to the drug library, which can be time-consuming. You’ll also need to consider that the differences in operation between the devices means that users will need to be retrained, and the differences in the log-analysis and library-editor tools may mean that you lose some of the expertise your administrators have developed from working with the previous system.
Ease of Use: A Critical Component of Infusion Pumps
Infusion pumps that are difficult to use may lead to problems such as dose errors and delays in patient care. Here’s a brief rundown of some ease-of-use problems hospitals may encounter, as well as developments that may help make pumps easier to use.
Infusion Technology Purchasing: It’s Not Just about Pumps
Choosing an infusion system is much more complicated than it used to be. Before making a decision, you’ll need to know the answer to some important questions.
Tips and Tools for a Smart Pump Clinical Assessment
Performing a meaningful clinical assessment of smart infusion pumps requires careful preparation. Here’s help in defining a process that will produce smart purchasing decisions and improve buy-in from your users.
Dose Error Reduction Systems: Features and Functions
Dose error reduction systems are life-saving safety features that help prevent infusion pump medication errors.
Infusion Pump Integration: Why Is It Needed, and What Are the Challenges?
The process of integrating your infusion pumps with your electronic medical record or other information systems has safety benefits, but it also poses numerous challenges. Find out what the difficulties are, and how to address them.
This article is excerpted from a digital story posted 2/25/15 on ECRI Institute’s membership website. The full article features additional background information and questions to ask during purchase. To learn more, visit www.ecri.org; call (610) 825-6000; or e-mail email@example.com
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