title: The impact of traditional and smart pump infusion technology on nurse medication administration performance in a simulated inpatient unit.
abstract: OBJECTIVE
  Assess the impact of infusion pump technologies (traditional pump vs smart pump vs smart pump with barcode) on nurses' ability to safely administer intravenous medications.
  
  
  METHODS
  Experimental study with a repeated measures design.
  
  
  METHODS
  High-fidelity simulated inpatient unit.
  
  
  RESULTS
  The nurses remedied 60% of "wrong drug" errors. This rate did not vary as a function of pump type. The nurses remedied "wrong patient" errors more often when using the barcode pump (88%) than when using the traditional pump (46%) or the smart pump (58%) (Cochran Q=14.36; p<0.05). The number of nurses who remedied "wrong dose hard limit" errors was higher when using the smart pump (75%) and the barcode pump (79%) than when using the traditional pump (38%) (Cochran Q=12.13; p<0.003). Conversely, there was no difference in remediation of "wrong dose soft limit" errors across pump types. The nurses' pump programming was less accurate when mathematical conversions were required. Success rates on secondary infusions were low (55.6%) and did not vary as a function of pump type.
  
  
  CONCLUSIONS
  These findings indicate that soft (changeable) limits in smart infusion pumps had no significant effect in preventing dosing errors. Provided that smart pumps are programmed with hard (unchangeable) limits, they can prevent dosing errors, thereby increasing patient safety. Until barcode pumps are integrated with other systems within the medication administration process, their role in enhancing patient safety will be limited. Further improvements to pump technologies are needed to mitigate risks associated with intravenous infusions, particularly secondary infusions.
authors.affiliation: Healthcare Human Factors, Centre for Global eHealth Innovation, University Health Network, Toronto, Ontario, Canada. patricia.trbovich@uhn.on.ca
authors.forename: P L
authors.initials: PL
authors.lastname: Trbovich
authors.forename: S
authors.initials: S
authors.lastname: Pinkney
authors.forename: J A
authors.initials: JA
authors.lastname: Cafazzo
authors.forename: A C
authors.initials: AC
authors.lastname: Easty
mesh_terms: D000293:Adolescent; D000328:Adult; D004358:Drug Therapy / Q000451:nursing*; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007297:Inpatients; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards*; D013647:Task Performance and Analysis; D055815:Young Adult