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March 2011, Volume 41 Number 3 , p 58 - 59


  • Kathleen Cummings BSN, RN
  • Ryan McGowan BS


LARGE-VOLUME, SYRINGE, and patient-controlled analgesia infusion pumps are commonly used in healthcare settings to deliver medications, fluids, and nutrients to patients at precisely controlled rates. In recent years, "smart" infusion pumps have become increasingly sophisticated and include such features as dose error reduction software, commonly referred to as drug libraries. This technology allows infusion pumps to perform functions that assist healthcare providers with programming and calculating dose and delivery rates. When used properly, these features help prevent I.V. medication errors and reduce patient harm.1However, these smart pumps can't prevent all programming and administration errors. Clinicians must use professional judgment and adhere to established standards of care and standard operating procedures for safe medication administration when using this or any other technology. (See Pumping up safety.)Drug libraries let clinicians select medications and fluids from preloaded lists, which can be tailored to each healthcare facility and patient care area. For example, a drug library profile used in an ICU would include vasoactive medications; one in a medical-surgical unit probably wouldn't.Some facilities also integrate smart infusion devices with electronic medical records, computerized order entry systems, and medication barcode scanning systems. Integrating these systems with smart pumps provides additional safety checks that may make administering I.V. medications safer.2Healthcare facilities may choose to implement limitations, commonly called hard and soft limits, on preselected drugs. If a clinician programs a smart pump outside predetermined dose or rate parameters for a drug with hard limits, the pump generates an alert and won't let the clinician proceed with the selection. Hard limits are typically set for high-risk drugs such as heparin. With soft limits, the clinician can override the alert and proceed with the infusion.2,3Despite advances

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