A decade of “smart” infusion pumps

Dr. Tim Vanderveen, Vice President of the Center for Safety and Clinical Excellence for CareFusion, discusses trends in medication management at CareFusion’s Online Center for Safety. In his most recent post, Dr. Vanderveen, who has authored several patents in infusion technology and was one of the original creators of smart IV pumps – spotlights the 10-year anniversary of smart infusion pumps. He discusses how smart pumps have evolved and provides a glimpse into the future of medication safety.

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In February, we recognized the 10-year anniversary of “smart” infusion pumps – infusion devices with Dose Error Reduction Software (DERS).

I have often been asked why it took so long for manufactures to add “guardrails” into infusion pumps. The short answer is that until it was possible for hospitals to create in their pumps custom drug libraries and best practice drug limits, the idea of adding safety alerts was only a dream. Each time we heard about a death or injury due to an incorrectly programmed pump, we could only hope that caregivers would be more careful in the future. This was of little comfort knowing how easy it was to make a mistake and how vulnerable nurses were without a safety net.

The technological breakthrough was the flash EPROM – basically, a chip that could be programmed with a hospital-specific drug library. Because drugs may be used off-label and IV practices are often not standardized, infusion pump manufacturers began to market “dumb” pumps that hospitals could make “smart.” Thinking back to the first Alaris® smart pumps, it’s amazing that even the initially limited capabilities had such a game-changing impact on our industry. Suddenly, we were in the software business and working feverishly to expand pump safety features to meet the demands of early adopters. We helped hospitals interpret data collected from the near misses and good catches, and we worked with customers and thought leaders to reduce practice and library variation, fine tune drug limits and interpret what Dr. David Bates called the new “treasure trove” of infusion data that was stored in each pump.

Studies have shown the typical adoption cycle for new technology in hospitals averages 20-years and could be even longer in some cases. The adoption of smart IV pumps, however, is almost 70% after only 10 years. One fact that has accelerated smart pump adoption is analogous to air bags in automobiles –the safety features now come standard. And, the “good catches” that pump logs document are evidence that pumps with DERS have prevented many potentially serious and possibly fatal errors.

Over the past 10 years, we have made tremendous progress in creating a safety net for drug administration. Looking ahead, the focus will be on making infusion pumps part of a much larger medication ecosystem, where pumps inherently administer accurate doses, expanding guardrails to patient – not drug – specific capabilities.

Find out more at CareFusion’s Online Center for Safety.