TechNation asked several healthcare technology management (HTM) professionals from throughout the nation to share their insights regarding IV pumps. Participating in this roundtable article are Adepto Medical’s Clint Creal, USOC Medical Technician Andrea Garcia, Avante Health Solutions (AHS) Lead Technician Zaolatt Laphai, MultiMedical Systems’ Israel Matamoros, Infusystem Vice President of Acute Care Austin Otto and Infusion Pump Repair Lead Technician Johnathan Romero.
Q: What is one thing every HTM professional should know about IV pumps?
Creal: Software is the name of the game now. Make sure you know what software level your pumps are at so that when you’re ordering rentals or additional units, they’ll be able to connect to your server and the drug library can be loaded onto the pumps. Drug libraries are a standard across the country now and clinicians will not want to use pumps that don’t have drug libraries on them. It’s important to match up all the software specifications prior to ordering additional pumps.
Garcia: When repairing an IV pump, one should keep in mind how critical accuracy is for these devices. While patient monitoring and parameter modules are important, those devices read vitals off a patient, while an infusion pump delivers fluids into a patient. It’s important to keep these things in mind because any bit of over or under delivery can result in a patient incident.
Laphai: One thing every HTM professional should know is that not all IV pumps are the same. They may all be designed to do the same thing (deliver fluids, nutrients, medications to patients), but their mechanisms of action are different. Two different types of pumps AHS services are Alaris 8100 Infusion Pumps and Medfusion 3500 Syringe pumps. Knowing what each type of pump’s specifications and functions are, while also maintaining proper maintenance, can ensure that this lifesaving equipment is performing to OEM specifications. Any inaccuracy could be potentially life threatening, depending on the medication being delivered.
Matamoros: Something like a hairline fracture in the bezel of an IV pump can cause the pump to be out of range. Calibrating the pump will not fix the issue if you’re not thorough enough. So, being thorough is never a negative thing when it comes to patient safety.
Otto: IV pumps require a lot of resources. PM and repair can take up 30% of the workload for a typical biomed department. Shops that have ample resources can keep up, but if staffing is low there are a lot of outside resources that can cost effectively help support this equipment. Although IV pumps take up a lot of time, they don’t have to take up a lot of expense.
Romero: From a technician’s point of view, being up to date with technology, especially software, is important to know. It is essential to be more familiar with software updates so that pumps can be more user-friendly and valuable. Being aware of the latest software can help save time and money.
Q: What are some cost-saving tips you can share regarding IV pumps?
Creal: Specialty pumps do not always need to go back to the manufacturer. Epidural/pain pumps and specialty syringe pumps are typically a lot fewer in quantity than the large volume pumps so it’s not worth sending a technician to OEM training to get certified for the few times they have to touch the pump a year. Parts for these unique pumps can also be expensive and some OEMs will not sell you parts unless you’ve been properly trained by them. There are many great vendors that can repair and service these pumps outside of the OEM and will typically have a lot faster turnaround time as well.
Garcia: By being proactive and staying up to date on your maintenance schedule you can prevent higher cost repairs by replacing minor overly used parts. Replacing parts like motors and clutch assemblies proactively can reduce the strain on higher cost parts, thereby increasing the longevity of some of the more expensive parts.
Laphai: One of the most cost-effective strategies that can be utilized is to invest in your HTM professionals’ IV pump training and always make sure your testing equipment is operating correctly and is up to date. Also, using OEM-compatible parts will minimize valuable technician time and eliminate incompatibility errors. Having commonly used parts on hand will keep downtime minimal. The less time a unit is out of circulation for repairs, the more time it is operational and helping patients.
Matamoros: Remember to save the tubing from the IV set. They always come in handy when you create a new test kit. Instead of ordering one from the manufacturer some OEM manuals give you a guide to create them.
Otto: Cutting cost is important for all equipment and IV pumps are no exception. Physical damage is the most expensive type of repair that can be mitigated with the right processes. A majority of physical damage occurs during cleaning and distribution along with improper handling of equipment. Looking at the trends within your facility and using that data to help educate other departments on proper procedures can have a large financial impact. Being involved with a mitigation plan through continuing education, physical damage and cost can be drastically reduced.
Romero: Preventive maintenance is my golden tip. When you get your IV pumps regularly checked, it can really extend the life of your pumps. We recommend getting them a PM and calibration at least once a year. As a technician, I’ve seen pumps look fine outside, but they look horrible and corroded inside. Save yourself time and stress by getting your pumps PM and calibrated.
Q: How has the COVID-19 pandemic impacted the use and maintenance/repair of IV pumps?
Creal: COVID definitely put a lot of stress on hospitals in regards to infusion pumps. A lot of facilities were scrambling around looking for additional units or resurrecting old units that were in storage. Some facilities purchased additional infusion pumps while others rented them. I do think that facilities will not want to go back to scrambling around so I think they’ll always keep an overstock of pumps as a reserve in case something like this were to happen again.
Garcia: IV pumps are widely used in the hospital more so than other devices, where typically each room will have one monitor and one parameter module, you will see multiple IV pumps in each room. Because of COVID-19, many hospitals have increased the amount of IV pumps they need on the floor at one time, which in turn has increased the amount of devices they need to send in for repair. It has turned into an all hands on deck situation where it is important to have as many IV pumps as possible ready as the hospital rooms have overflowed numerous times.
Laphai: The COVID-19 pandemic has and is still impacting the use and maintenance/repair of IV pumps. As an integral part of patient care, IV pumps are in constant use and in constant need of repair/service during a normal season. During this pandemic, it has skyrocketed exponentially. Supply chain issues have strained resources to procure much needed parts that were, previously, readily available. Demand has driven up costs, and that affects facility budgets. Purchasing departments are now being proactive and ordering ahead and ordering in bulk.
Matamoros: Pumps are being used more frequently and, because of this, checking calibration often is a must. COVID-19 has made it difficult to gather pumps that are in need of a PM. To assist with this, we have engaged the nursing leadership more than in the past to assist with locating devices.
Otto: The pandemic has brought to the forefront the importance of IV pumps. It showed how valuable an accurate inventory can be and gave RTLS a new look. The pandemic also showed how important it is to have a well-planned maintenance program and the importance of using the right part suppliers and repair depots for quick turnaround and support.
Romero: COVID-19 has created an influx in demand for us, increasing turnaround time to about 7-10 business days. So, we are busy. But we are working to support our customers in all capacities, decrease the turnaround time and meet the high demand.
Q: How important are PMs and why?
Creal: In our world at Adepto, every pump needs to have a PM and a recertification sheet before it leaves our facility stating that the pump is running accurately and within spec. However, that is our world since we are liable for that equipment when it is sent to a hospital. On the other hand, I have spoken to a few biomed directors that no longer run annual PMs on their infusion pumps. Studies have shown that of the annual PM process, only a select few pumps are out of calibration. So, the time and energy it takes to PM over a thousand pumps annually can be put towards staying up to date on other equipment.
Garcia: Preventative maintenance (PMs) are extremely important in ensuring the delivery accuracy of these devices. PMs are not something that one can be lackadaisical about as accurate infusing of medication and fluids can be integral in the recovery process. One should treat the care and maintenance of these devices as if they will be used on themselves or a family member one day.
Laphai: PMs are critical and need to be conducted in a timely manner. We cannot assume the accuracy of these units because it can result in the life or death of a patient. Routine maintenance will ensure these units can be trusted to perform in their expected manner and with so many ways to make a mistake, this is one simple remedy that can be quickly enforced and trusted. The benefit of eliminating human error when testing the accuracy of these devices cannot be understated.
Otto: Preventive maintenance on IV pumps is extremely important. It ensures that not only the device is functioning properly but allows that device to be inspected by a qualified technician on an annual basis. PMs can help with tracking trends within a facility, limit unplanned downtime and mitigate issues before they can impact patient care.
Matamoros: Performing a PM is highly recommended because maintaining accuracy on a device that is delivering various medications is key to patient safety. Without annual maintenance, patient lives could be at risk. So, being thorough with your PMs is never a negative thing.
Romero: Think of PMs like a yearly doctor visit. When we visit the doctor, we can evaluate our health and prevent severe health conditions. PMs are the same. When evaluations only occur in an emergency, things become more complex and costly. PMs are important because they can prevent and reduce issues in advance.
Q: What else do you think TechNation readers need to know about purchasing and servicing IV pumps?
Creal: There are a lot of companies out there that can repair infusion pumps. It’s probably the farthest you can get from rocket science. However, if you are sending equipment out to be serviced or purchasing additional pumps … make sure it’s through a vendor you know and trust. Pumps are relatively inexpensive within the medical world, but don’t always chase the cheapest price. If you value quality, work with a vendor that tracks their warranties and meets about them to discuss ways to improve. Everybody says they have high-quality equipment but work with a vendor that believes it and practices it weekly!
Garcia: When purchasing an IV pump it’s important to know where to access and locate software information on the pump. This will prevent possible compatibility issues when putting the unit into service. Always service the device following all ESD standards and with the utmost care. Keep a strict maintenance schedule so that units can be switched out when service or PMs are due, and never put a unit back into service without first performing the PM.
Laphai: Selecting and servicing the correct infusion pump for your clinical needs is an important task. The cost and availability of sets and intervals of PMs should be factored into your decision, and you need a reliable service provider to keep you up and running.
Matamoros: Make sure to always use calibrated test sets and distilled water when testing an IV pump. Always keep track of how many uses your calibrated IV set has and prior to starting check the expiration date. Using a non-calibrated set can make the pump unable to recognize whether the IV set is defective. There is nothing better than accuracy.
Otto: Due diligence has never been more important when considering buying or renting IV pumps. Recalls and supply chain disruptions have made what used to be easy decisions complicated. Make sure you ask the right questions of your equipment and/or service provider because the IV pump industry is fluid at this point. It’s easy to get a great sale or rental price on IV pumps, but the challenge relative to getting associated sets and working around recalls should be top of mind.
Romero: I think research is vital for TechNation readers to know. They should be researching the IV pumps they want to purchase or service. Readers need to explore and understand how software updates can affect patient treatments.
