Modern smart infusion pumps are wirelessly connected to a network server for easy data communications. The two-way communication allows uploading of infusion data and downloading of drug library updates. We have discovered significant delays in library updates. This research aimed at studying the drug library update process of one vendor pump and the contributing factors of pump update delays. Our data included BD Alaris™ pump status and infusion reports of two hospital systems (92 and 80 days, respectively, in 2015). We analyzed drug library update progressions at the individual device and fleet levels. To complete a library update, a pump goes through two status transitions: from noncurrent to a new library pending, and from pending to current. On average it took five to nine days for 50% of a pump fleet to become current after a new drug library was disseminated. We confirmed factors that affect noncurrent-to-pending time to include time to first power-on and total power-on time. We also found that high pump utilization promotes shorter pending-to-current time. Two distinctive and important steps of a drug library update on Alaris™ pumps are pending a new library and completing the library installation. To avoid potential patient harm caused by infusion pumps without appropriate drug limits due to update delays, hospitals should monitor the progression of a drug library update on its pump fleet. Potential ways to improve drug library updates on a fleet of pumps include better technologies, improved pump user-interface design, and more staff training.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
O'Byrne, N., Kozub, E. I., and Fields, W., Reducing continuous intravenous medication errors in an intensive care unit. J. Nurs. Care Qual. 31:13–16, 2016.
Giuliano, K. K., and Niemi, C., The urgent need for innovation in IV smart pumps. Nurs. Manag. 46:17, 2015.
Bitan, Y., and Nunnally, M. E., Can a log of infusion device events be used to understand infusion accidents? J Patient Saf 3:208–213, 2007.
Institute for Safe Medication Practices, Proceedings from the ISMP summit on the use of smart infusion pumps: Guidelines for safe implementation and use, 2009. http://www.ismp.org/guidelines/safe-implementation-and-use-smart-pumps. Accessed 24 October 2017
Pedersen, C. A., and Gumpper, K. F., ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in US hospitals—2007. Am J Health-Syst Pharm 65:2244–2264, 2008.
Skledar, S. J., Niccolai, C. S., Schilling, D. et al., Quality-improvement analytics for intravenous infusion pumps. Am J Health-Syst Pharm 70:680–686, 2013.
DeLaurentis, P.C., Hsu, K.-Y., De la Armenta, A.I.H., Bitan, Y., Investigating delays in updates to infusion pump drug limit libraries. AMIA Annu Symp Proc. 2016.
DeLaurentis, P., Hsu, K.-Y., and Bitan, Y., Prevalence of wireless smart infusion pump drug library update delays. Am J Health-Syst Pharm 75:1140–1144, 2018.
Manrique-Rodríguez, S., Sánchez-Galindo, A. C., López-Herce, J. et al., Risks in the implementation and use of smart pumps in a pediatric intensive care unit: application of the failure mode and effects analysis. Int. J. Technol. Assess. Health Care 30:210–217, 2014.
Becton, D., and Company, Activating a new data set (drug library) with the BD Alaris™ System, 2018. https://www.bd.com/documents/guides/tip-sheets/IF_Alaris-System-activating-new-data-set_TS_EN.pdf. Accessed 24 April 2018
Poppe, L. B., and Eckel, S. F., Evaluating an approach to improving the adoption rate of wireless drug library updates for smart pumps. Am. J. Health Syst. Pharm. 68:170–175, 2011.
The authors greatly appreciated the data and expertise provided by the community of the Regenstrief National Center for Medical Device Informatics (REMEDI) supported by the Regenstrief Center for Healthcare Engineering at Purdue University. This work was partly supported by the Regenstrief Foundation.
This study was partly funded by the Regenstrief Foundation.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Systems-Level Quality Improvement
About this article
Cite this article
Hsu, K., DeLaurentis, P., Yih, Y. et al. Tracking the Progress of Wireless Infusion Pump Drug Library Updates– A Data-Driven Analysis of Pump Update Delays. J Med Syst 43, 75 (2019). https://doi.org/10.1007/s10916-019-1189-5
- Infusion pumps
- Patient safety
- Medical informatics
- Medical device