Tracking the Progress of Wireless Infusion Pump Drug Library Updates– A Data-Driven Analysis of Pump Update Delays

Abstract

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.

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References

  1. 1.

    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.

    Article  Google Scholar 

  2. 2.

    Giuliano, K. K., and Niemi, C., The urgent need for innovation in IV smart pumps. Nurs. Manag. 46:17, 2015.

    Article  Google Scholar 

  3. 3.

    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.

    Article  Google Scholar 

  4. 4.

    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

  5. 5.

    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.

    Article  Google Scholar 

  6. 6.

    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.

    CAS  Article  Google Scholar 

  7. 7.

    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.

  8. 8.

    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.

    Article  Google Scholar 

  9. 9.

    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.

    Article  Google Scholar 

  10. 10.

    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

  11. 11.

    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.

    Article  Google Scholar 

Download references

Acknowledgements

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.

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This study was partly funded by the Regenstrief Foundation.

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Correspondence to Poching DeLaurentis.

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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

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Keywords

  • Infusion pumps
  • Patient safety
  • Medical informatics
  • Medical device