From the Elaine Marieb Center for Nursing and Engineering Innovation, Institute for Applied Life Sciences and Elaine Marieb College of Nursing, University of Massachusetts Amherst.
Education, Melrose-Wakefield Healthcare.
J Patient Saf. 2022 Sep 1;18(6):553-558. doi: 10.1097/PTS.0000000000001057. Epub 2022 Aug 6.
This study was conducted to advance understanding of intravenous (IV) smart pump medication administration practices using the Baxter Spectrum IQ. The primary objective was to observe adherence with manufacturer required IV smart pump system setup at the point of care during actual clinical use.
The study was conducted in a 285-bed acute care community hospital near Boston, Massachusetts. The study design was observational and noninterventional, and all data were collected by a single observer. Observations included measurement and documentation of adherence with the Baxter Spectrum IQ system setup requirements.
A total of 200 primary and secondary IV medication administration observations were included: 101 in critical care and 99 in medical-surgical. Overall adherence was found to be: 6.5% with IV smart pump position relative to the patient (aim 1); 6.5% with required position of the primary infusion bag (aim 2); and 69.5% adherence with required position of the secondary medication infusion bag (aim 3). Additional exploratory data were also collected.
These results add to the emerging body of knowledge, which support that adherence to required system setup for head-height dependent IV smart pumps is low and difficult to achieve during actual clinical use. Consideration of alternative human factors-designed technology to replace the current manual setup requirements is needed to improve the process of acute care IV medication administration in this very important area of patient safety.
本研究旨在深入了解 Baxter Spectrum IQ 型静脉（IV）智能输液泵的给药实践。主要目的是观察在实际临床使用中，医护人员在进行治疗时是否遵循制造商规定的 IV 智能输液泵系统设置要求。
该研究在马萨诸塞州波士顿附近的一家拥有 285 张病床的急性护理社区医院进行。研究设计为观察性和非介入性，所有数据均由一名观察员收集。观察内容包括测量和记录 Baxter Spectrum IQ 系统设置要求的遵守情况。
共纳入 200 次 IV 药物给药的主要和次要观察：101 例在重症监护病房，99 例在普通病房。总体依从率为：相对于患者的 IV 智能输液泵位置（目标 1）为 6.5%；主要输液袋的必需位置（目标 2）为 6.5%；次要药物输液袋的必需位置（目标 3）为 69.5%。还收集了额外的探索性数据。
这些结果增加了新知识体系，支持了头高位依赖型 IV 智能输液泵的系统设置要求的依从性很低，并且在实际临床使用中难以实现。需要考虑替代人为因素设计的技术来取代当前的手动设置要求，以改善这个对患者安全非常重要的急性护理 IV 药物给药流程。
