title: Quality-improvement analytics for intravenous infusion pumps.
abstract: OBJECTIVE
  The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement.
  
  
  CONCLUSIONS
  Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs.
  
  
  CONCLUSIONS
  A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.
authors.affiliation: Pharmacy Drug Use and Disease State Management Program, Department of Pharmacy, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA 15213, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Skledar
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Niccolai
authors.forename: Dennis
authors.initials: D
authors.lastname: Schilling
authors.forename: Susan
authors.initials: S
authors.lastname: Costello
authors.forename: Nicolette
authors.initials: N
authors.lastname: Mininni
authors.forename: Kelly
authors.initials: K
authors.lastname: Ervin
authors.forename: Alana
authors.initials: A
authors.lastname: Urban
mesh_terms: D061605:Administration, Intravenous; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects / Q000592:standards*; D008508:Medication Errors / Q000517:prevention & control*; D017749:Total Quality Management / Q000379:methods*