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

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.

[1]  C. Fernández-Llamazares,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 , 2014, International Journal of Technology Assessment in Health Care.

[2]  K. Giuliano,et al.  The urgent need for innovation in I.V. smart pumps. , 2015, Nursing management.

[3]  Nicolette C. Mininni,et al.  Quality-improvement analytics for intravenous infusion pumps. , 2013, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[4]  Yuval Bitan,et al.  Investigating Delays in Updates to Infusion Pump Drug Limit Libraries , 2016, AMIA.

[5]  C. Pedersen,et al.  ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in U.S. hospitals--2007. , 2008, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[6]  W. Fields,et al.  Reducing Continuous Intravenous Medication Errors in an Intensive Care Unit , 2016, Journal of nursing care quality.

[7]  Stephen F Eckel,et al.  Evaluating an approach to improving the adoption rate of wireless drug library updates for smart pumps. , 2011, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[8]  Yuval Bitan,et al.  Prevalence of wireless smart‐pump drug library update delays , 2018, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[9]  Yuval Bitan,et al.  Can a Log of Infusion Device Events Be Used to Understand Infusion Accidents? , 2007 .