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Objectives of Canadian Infusion Pump Survey

Objectives of Canadian Infusion Pump Survey. To explore the existing level of infusion pump problems in Canadian Hospitals To obtain data on pump problems experienced in Canadian Hospitals To prioritize infusion pump issues To develop strategies for safer infusion pump use

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Objectives of Canadian Infusion Pump Survey

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  1. Objectives of Canadian Infusion Pump Survey • To explore the existing level of infusion pump problems in Canadian Hospitals • To obtain data on pump problems experienced in Canadian Hospitals • To prioritize infusion pump issues • To develop strategies for safer infusion pump use • equipment and practice

  2. ISMP Canada Infusion Pump Safety Project Pump Problems Encountered (n=340) 300 250 200 Number of Responses 150 255 (75%) 100 50 85 (25%) 0 No Yes Response

  3. ISMP Canada Infusion Pump Safety Project Pump Problems Encountered by Hospital Type (n=340) 140 115 (77.2%) 120 102 (70.8%) 100 80 Number of Responses 60 42 (29.2%) 35 (85.4%) 40 34 (22.8%) 20 6 (14.6%) 3 (50%) 3 (50%) 0 Community (Non- Community (Teaching) Teaching Unknown Teaching) Hospital Types No Problems (Total = 85) With Problems (Total = 255)

  4. ISMP Canada Infusion Pump Safety Project Top 10 Pump Problems (n=340) 160 148 147 140 120 99 97 100 91 Number of Responses 80 69 65 60 52 52 50 40 20 0 Door Open Flow Rate- OD False Air in Line Stopped/ Shut Off Flow Rate- Freeflow Battery Failure- No Alarm Flow Rate- Incorrect Rate No Free Flow Mechanism Tubing position-Free Flow Syringe Incorrectly Engaged Major Problem Types

  5. ISMP Canada Infusion Pump Safety Project Pump Problems Reported in Percentages 70 58.2 57.9 60 50 47.4 47.1 43.9 42.9 38.8 40 35.6 Number of Responses (%) 28.6 30 22.9 20 10 0 Free Flow Flow Rate Over Dose Air Sensor Other Major Problem Types Total Aggregate (n=340) Ontario Responses (n=98)

  6. ISMP Canada Infusion Pump Safety Project Top 5 Desired Pump Improvements (Total=231) 140 118 115 120 112 100 93 88 80 Number of Responses 60 40 20 0 A B C D E Type of Improvement A. On screen programming instructions B. Protocol programming C. Ability to program clinical minimum/maximum drug concentrations or dosing parameters D. Clarity of display E. Ability to program ‘primary’ versus ‘secondary” infusion rates

  7. Comments Received Free Flow (26): • “set removed from pump without clamping” • Tubing: • “if tubing is removed incorrectly during cleaning damage may occur with pieces of tubing not visible remaining inside mechanism. If new tubing inserted freeflow situation can occur” • “tubing stretched out too much” • “Free flow mixing with primary and secondary IV dose occur”

  8. Comments Received Overdose (23): • “set removed without clamping” • “with a CADD pump” • Equipment: • “defective part” • “dirty detection sensor” • “failure of pumping mechanism-too much fluid went through in a short time, one time” • “Pump programmed in mLs/ min instead of mLs/ hr”

  9. Comments Received Overdose continued: • “Epidural concentration set at peripheral rate” • “…when there are too many lines and nurse confuses the settings.” • “tubing not positioned properly in pumping mechanism” • “...syringe loaded incorrectly and pump read incorrect size of syringe and continued to infuse.”

  10. Comments Received Incorrect Flow Rate (34): • Battery • “suspected source undetermined” • “patient initiated” • “primary infusing instead of secondary” • EMI • Equipment

  11. Comments Received Incorrect Flow Rate continued: • “PCA-wrong end of tubing attached to medication bag-pump did not alarm” • Incorrect input of medication concentration • “Lines switched to wrong channel” • “Problem with one brand of syringes which was used in the syringe pumps. Pump would miscalculate syringe size….”

  12. Comments Received False Air in Line (16): • “have had incidents where the tubing was completely empty and the alarm didn't go off and other times, the alarm would go off because of a tiny bubble of air hardly visible to the human eye” • “false air in line alarm ,especially when running albumin”

  13. Smart Pumps • Medley by Alaris Medical Systems • Colleague CX by Baxter Healthcare Corporation • B. Braun

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