Evidence-Based Outcomes
Improved outcomes using real-time data, retrospective reporting and analytics
Interoperability outcomes
Pump It Up! Elevating Smart Pump Interoperability through Education and Training
Abstract: A large, multi-facility healthcare organization has achieved success with smart pump interoperability by uniting technology, a culture of safety, and collaboration with their pump vendor. The objective was to implement a system-wide standardized training methodology, which included mandatory two-hour hands-on training sessions to walk through various workflow scenarios, competency evaluations, early manager involvement and weekly check-ins. Their commitment to patient safety led to a 97% auto-programming success rate, drug library override rates decreased from 26% to 7% and zero adverse infusion-related events (Q1 2023).
Reference: Kepner P, Filipski P, Guard N, Edwards J, Parry D, Showman K, Rowe A, Belford L. Pump It Up! Elevating Smart Pump Interoperability through Education and Training. Research poster presentation for the American Nursing Informatics Association, Chicago, IL, May 2024.
Outcomes from a Smart Infusion Pump and Electronic Health Record Integration: Improved Patient Safety, Nursing Efficiency and Return on Investment
Abstract: A four-time Magnet hospital successfully integrated Space® Infusion Pumps and the electronic medical record, documenting a 27% decrease in infusion medication events, sustained drug library compliance >95% and a low-alert override rate of <5%. Smart pump auto-programming reduced pump programming times by as much as 77% and integration with RTLS reduced staff time spent on asset management by 49%. Improved documentation resulted in a 25% increase in captured outpatient infusion charges which, if annualized, could equal $957,696 in increased gross charges.
Is Perception Reality? Nurses’ Expectations of Smart Pump-EHR Interoperability
Abstract: Voted Top Scoring Poster by ANIA, this survey based study explored the perceptions of medical/surgical and intensive care unit nurses throughout a smart pump-EHR interoperability implementation. While nurses thought interoperability improved safety, was easy to learn and improved programming time, expectations of time/efficiency and programming confidence decreased. This study underscored the impact of interoperability on clinical workflows and the need for continued support long after implementation. The organization’s nurse informaticist is critical to help drive change, manage expectations and measure performance, enlisting super users to address workflow issues in real-time and build confidence.
Reference: Johnston S, Schuster C, Vitoux RR, Bartos D, Curtin CR. Is perception reality? Nurses’ expectations of smart pump-EHR interoperability. Research poster presentation for the American Nursing Informatics Association, Louisville, KY, May 2023.
Impact of Smart Pump Interoperability: Reducing Alerts and Improving Safety
Abstract: A hospital-wide EMR Integration with Space® Infusion Pumps led to measurable, data-based improvements in IV medication safety. This hospital demonstrated these improvements by measuring drug library compliance and alert override data pre- and post-integration. The hospital increased its already impressive 96% drug library compliance to 98% post integration compared to the national average of 81%, and reduced its alert override frequency by 92%, achieving a 9% override response rate compared to the national average of 76%. In addition, one year post integration there were no reported smart pump-related errors.
Reference: Wong S, Maier J, Ahdab A, Cody P, Vitoux R, Johnston S. Impact of smart pump interoperability: Reducing alerts and improving safety. Poster presented at: American Nursing Informatics Association; 2021.
Smart Pump outcomes
Improving Smart Pump Drug Library Upload Success Using a Best Practice Approach
Abstract: Steward Health implemented a Drug Library Best Practice approach, including establishment of an enterprise multidisciplinary pump subcommittee, standardization of the infusion drug library across a 34-hospital system and designation of facility pump update safety leads. Data was collected after a baseline drug library push and following implementation of the best practice approach at three hospitals using the Infusomat® Space® Large Volume Pump. DoseTrac® Infusion Management Software was used to deploy the drug library, monitor distribution in real time and track pump drug library upload success – which included 90% of pumps receiving the updated library in three hours and 100% in 10 days. Both technology and practice played a role in this success.
Reference: LeFever NC, Martin E, Small J, Drelick J, Vitoux RR. Improving smart pump drug library upload success using a best practice approach. Research poster presented at IHI Forum, Orlando, FL, December 2022.
Smart Pumps. Positive Outcomes.
Abstract: A retrospective review of data from over 11,000 Space® Pumps found an average drug library compliance of 96% and a 2% of infusion time in alarms state. The unique insight of B. Braun’s DoseTrac Analysis Service has helped customers identify high-risk practices and optimize drug library compliance. In one facility, drug library changes, combined with process improvements, led to a 92% reduction in overrides and sustained a drug library compliance of 97-98%.
Reference: B. Braun Medical Inc. Data on File.
Achieving Outcomes with Innovative Smart Pump Technology: Partnership, Planning and Quality Improvement
Abstract: A 5‐time designated Magnet academic medical center partnered with B.Braun Medical to successfully integrate 1327 smart pumps across 45 departments in an aggressive 3‐month timeline. Quality improvement outcomes included 100% drug library compliance across all 6 intensive care units, a decrease in pump alert rate from 4.18% to 0.79% and a decrease in pump programming correction rate from 0.36% to 0.06%.
Reference: Lehr J, Vitoux RR, Zavotsky KE, Pontieri‐Lewis V, Colineri L. Achieving outcomes with innovative smart pump technology: Partnership, planning and quality improvement. J Nsg Care Qual, 2018; April 9 [Epub].
Establishing Benchmarks and Identifying Opportunities to Reduce Alert Fatigue Associated with Smart Infusion Pumps
Abstract: Alert analysis of over 4 million infusion therapies across 50 U.S. hospitals found only 1% of therapies were associated with dosing alerts, with only a 0.1% correction frequency. This low correction rate indicates a low incidence of programming error associated with single channel pumps with non-numeric keypads. Alert analysis with drug library adjustments and education has helped hospitals achieve up to 99% reduction in alerts, up to 100% drug library use, and a significant reduction in infusion related medication errors.
Reference: Vitoux R, Chang H, Lehr J. Establishing benchmarks and identifying opportunities to reduce alert fatigue associated with smart infusion pumps. Poster presentation at the American Society of Health-System Pharmacists Midyear Clinical Meeting, Las Vegas NV, December 2015.
The Crucial Link in Successful Smart Pump Adoption: The Critical Care Nurse
Abstract: Successful adoption of smart pump and related technologies requires ongoing communication, collaboration and partnership to achieve sustainable impact on patient safety outcomes. The authors discuss the phases of smart pump adoption and the role of the critical care nurse in helping to achieve patient safety outcomes and zero IV pump‐related errors.
Reference: Kavanagh T, Tse E, Vitoux R. The crucial link in successful smart pump adoption: The critical care nurse. Can J Crit Care Nurs, 2017; 28(4): 29‐34.
Alarm outcomes
Frequency and Duration of Infusion Pump Alarms: Establishing National Benchmarks
Abstract: Voted Best Research Article of 2018 by the BI&T Editorial Board. Baseline of infusion pump alarm types, frequencies and duration were established based on data across 29 hospitals using 11,410 B. Braun infusion pumps. While there were 987,240 alarms associated with 568,164 deliveries, pump alarms accounted for only 0.8% of infusion time with an average of 1.74 alarms per delivery and 0.18 alarms per hour; with 60% addressed within 0:01:08. Top alarms by alarm type, care unit, drug name and day of week are discussed.
Reference: Vitoux RR, Schuster C, Glover KR, Dekker M. Frequency and duration of infusion pump alarms: Establishing national benchmarks. Biomed Instrum Technol, Nov/Dec 2018; 52(6): 433-411.
Methodology for Ensuring Accuracy and Validity of Infusion Pump Alarm Data
Abstract: This article explains the complexities of collating infusion pump alarm data across multiple hospital datasets and describes a research‐based process to maximize the accuracy and validity of the data. Finding no comparable process in the literature, the researchers created and tested a validation methodology to ensure accurate and valid reporting of infusion alarm data metrics and benchmarks.
Reference: Schuster C, Vitoux R. Methodology for Ensuring Accuracy and Validity of Infusion Pump Alarm Data. Biomed Instrum Technol, 2018; 52(3): 192‐198.
Perceptions of Infusion Pump Alarms: Insights Gained from Critical Care Nurses
Abstract: The authors developed and used an infusion pump‐specific alarm survey to measure nurse perceptions of pump alarms and compared the results with those reported by studies that measured clinical alarms in general. The findings indicated that nurses overwhelmingly agree that infusion pump nuisance alarms occur frequently and disrupt patient care, but nurses’ perceptions of pump alarms are different from those previously reported for clinical alarms in general.
Reference: Vitoux R, Schuster C, Glover G. Perceptions of infusion pump alarms: Insights gained from critical care nurses. J Infus Nurs, 2018; 41(5): 309‐318.
Types and Frequency of Infusion Pump Alarms: Protocol for a Retrospective Data Analysis
Abstract: Since research related to the types and frequencies of actionable infusion pump alarms remains largely unexplored, this study protocol is designed to provide new insights regarding the types and frequency of infusion pump alarms. Infusion pump alarm data collected and analyzed in this study will be used to help establish a baseline of infusion pump alarm types and relative frequencies.
Reference: Glover KR, Vitoux RR, Schuster C, Curtin CR. Types and frequency of infusion pump alarms: Protocol for a retrospective data analysis. JMIR Res Protoc, 2018; 7(6):e10446
Studying Air-in-Line Alarms: Fewer Air-in-Line Alarms on the B. Braun Infusomat® Space® Large Volume Pump
Abstract: Based on an internal analysis to determine the frequency and rate of air-in-line (AIL) alarms, the innovative Infusomat® Space® Pump exhibited less than 4 AIL alarms per pump per month and a 7% average AIL rate in 4 acute care hospitals across the U.S. Compared to a competitive pump in one hospital, the Infusomat Space is associated with 67% fewer AIL alarms.
Reference: B. Braun Medical Inc. Data on File. 2019.