What are smart pumps?

Different medications are given to patients in different ways. Some medications are taken by swallowing pills. Some are injected into the body using needles. Many medications that are given to hospital patients are administered intravenously -- directly into a patient's veins. That is often called I.V. medication by health professionals.

I.V. medications are injected into a patient's bloodstream using a pump. A health care provider, such as a nurse, sets the pump to automatically give a specific amount of medication (called the dose) over a certain amout of time (called the rate).

At University of Missouri Health Care, we use computerized "smart pumps" that check that the right dose is given to the patient at the right rate. Smart pumps can alert nurses if the medication is being given too quickly, too slowly or in too large or too small a dose.

How are we doing, and what are we doing to improve?

University of Missouri Health Care began implementing smart pumps in 2007. We use three types of pumps that are designed for different forms of medications:

• Infusion pump
• Syringe pump
• Patient-controlled analgesia (pain medication)

All of University of Missouri Health Care's smart pumps automatically collect information on how the pumps are being used. That information is then compiled into a computer database that our Office of Clinical Effectiveness tracks. Once every three months, a multidisciplinary team of nurses and physicians evaluates the data and looks for ways to improve use of the pumps. For example, if nurses regularly receive alerts from the pumps because their patients require higher levels of medication, the pumps may be reprogrammed to allow higher doses without an alert being made.

In our hospitals, we have 100 percent smart infusion pumps and 100 percent patient-controlled analgesia smart pumps. We are in the process of converting to 100 percent smart syringe pumps.

More medication safety measures

• Computerized Provider Order Entry (CPOE)
• Barcoding / electronic medication administration record (eMAR)
• E-Prescribing

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