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Beyond the pump — Interoperable infusion systems

May 31, 2019
Infusion Pumps
From the May 2019 issue of HealthCare Business News magazine

Most recently, ECRI Institute's 2019 list stressed that even pumps that incorporate a DERS can be misprogrammed in a way that could lead to patient harm. That report highlighted the risks associated with wrong-field programming errors, such as the dose rate being entered into the flow rate field, or vice versa. DERS has been the standard of infusion safety, providing user notifications and drug-based dosing limits that can help minimize use errors. However, in a high stress clinical environment, a programming error could still occur and have devastating consequences, depending on the medication and the patient. In addition to wrong-field programming errors, common reports of safety issues include overriding important DERS safety alerts or bypassing the safety software altogether.

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Despite the significant advances in infusion pump technology over the past decades, ECRI Institute still continues to investigate numerous accidents and problems related to infusion pump programming errors, misuse, and malfunctions, which can, in the worst case scenario, lead to patient harm.

Next generation of infusion safety technology — infusion pump integration
The traditional definition of an infusion pump is changing, as pumps are integrated into the larger hospital IT ecosystem to achieve additional patient safety and clinical workflow benefits. Pump interoperability or pump integration has become the focus of the next era in infusion pump safety technology.

ECRI Institute defines pump integration as follows: “The creation of an electronic connection between an infusion pump channel and an electronic medical record (EMR) system. This connection allows the pump channel, the patient, and a medication order to be associated with each other, which aids in safe medication administration and timely, accurate, consistent documentation of infusion data.” This electronic connection is normally created by utilizing a bedside barcode scanner.

Infusion pump integration involves both of the following:
Autoprogramming — Infusion program parameters, such as flow rate, dose, and patient weight, are populated from the EMR to the pump, based on a provider order.
Autodocumentation — Infusion information, such as intake data, dose/rate changes, and IV stop time, is sent to the EMR system for manual clinician confirmation to enable accurate recording of this infusion information in the patient's record after the infusion is started.

Pump integration, including autoprogramming and autodocumentation, is now available from most infusion pump vendors, with manufacturers reporting that well over 400 facilities have completed pump integration projects.

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