Regenstrief Center for Healthcare Engineering, School of Industrial Engineering, Purdue University, West Lafayette, IN, 47907, USA.
Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, 47907, USA.
J Med Syst. 2019 Feb 12;43(3):75. doi: 10.1007/s10916-019-1189-5.
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.
现代智能输液泵通过无线网络与网络服务器连接，便于进行数据通信。双向通信允许上传输液数据和下载药物库更新。我们发现药物库更新存在明显延迟。本研究旨在研究一种供应商输液泵的药物库更新过程以及导致泵更新延迟的因素。我们的数据包括 BD Alaris™ 泵状态和两个医院系统的输液报告（2015 年分别为 92 天和 80 天）。我们分析了个体设备和机群级别的药物库更新进展。为了完成药物库更新，泵需要经历两个状态转换：从非当前状态到新药物库待处理，以及从待处理状态到当前状态。平均而言，在新药物库发布后，需要五到九天的时间，泵机群的 50%才能达到当前状态。我们确认了影响非当前状态到待处理时间的因素，包括首次开机时间和总开机时间。我们还发现，高泵利用率可以缩短待处理到当前状态的时间。在 Alaris™ 泵上，药物库更新有两个独特且重要的步骤，分别是等待新的药物库和完成药物库安装。为避免因更新延迟而导致输液泵无适当药物限制而对患者造成潜在伤害，医院应监测其泵机群的药物库更新进展。改善泵机群药物库更新的潜在方法包括改进技术、改进泵用户界面设计以及加强员工培训。
