Using a high-fidelity patient simulator, this study had nurses evaluate the advanced features of an intravenous (IV) infusion pump being considered for purchase by a large Canadian health region. Three use cases or scenarios were developed, based on known difficulties administering multiple drugs through separate IV lines and the potential for certain drugs (e.g., heparin) to contribute to adverse outcomes in patients if the drug dosage was incorrectly calculated. After an in-service training session with the pump, thirteen nurses performed the use cases on an Emergency Care Simulator, which displayed a range of vital signs. During the sessions, nurses were required to use a think-aloud protocol, verbalizing all steps they were performing. The most common problems found were with the “Change Mode”and the “Select New Patient”features. Use of the On/Off switch was identified as a common strategy to clear pump information and to escape incorrect navigation paths. The consequential contribution to patient safety of these problems ranged from non-hazardous to potentially very hazardous. A number of design recommendations were made to address problems that were identified with the pump's hardware and software configurations, as well as to any in-service provided to new pump users.
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