Impact of smart infusion technology on administration of anticoagulants (unfractionated Heparin, Argatroban, Lepirudin, and Bivalirudin).
This study reviewed 863 alerts generated from the infusion of anticoagulants in 355 patients from October 2003 to January 2005. Alerts were generated by smart infusion technology pumps and recorded in the devices' memory. The most common alerts were underdose alerts (59.8%), followed by overdose alerts (31.3%) and duplicate drug therapy alerts (8.9%). In response to the alerts, users' most frequent action was to cancel (46.5%) or reprogram (43.1%) the infusions. The highest percentage of alerts occurred from 2 to 4 p.m. During the study, there were 4 infusion rate errors, compared with 15 in the immediately preceding 16-month period. In conclusion, smart infusion technology intercepted keypad entry errors, thereby reducing the likelihood of intravenous anticoagulant overdose or underdose. Dose or infusion rate programming during intravenous anticoagulation is an important targets for medication safety interventions.
Fanikos
John
J
Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Fiumara
Karen
K
Baroletti
Steve
S
Luppi
Carol
C
Saniuk
Catherine
C
Mehta
Amar
A
Silverman
Jon
J
Goldhaber
Samuel Z
SZ
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001120:Arginine / Q000031:analogs & derivatives; D001900:Boston; D062787:Drug Overdose; D004360:Drug Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006629:Hirudins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008508:Medication Errors; D008510:Medication Systems, Hospital; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000009:adverse effects; D010875:Pipecolic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012107:Research Design; D013449:Sulfonamides
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D010875:Pipecolic Acids; D011994:Recombinant Proteins; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban; C074619:bivalirudin; C083544:lepirudin