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Patient Safety

How IV Pump Optimization is Helping Prevent Medication Errors

Michelle Mandrack, MSN, RN

Director of Consulting Services, Institute for Safe Medication Practices 

Almost 20 years ago, the introduction of smart intravenous (IV) infusion pumps with dose error alerts and associated drug libraries launched an era of dramatic improvements in IV safety. Smart infusion pumps are now used in more than 80% of US hospitals and are widely regarded as a standard of care to reduce infusion-related medication errors. 

Smart pumps have helped ensure a greater level of control, accuracy, and precision with drug delivery, and are designed to provide healthcare practitioners with warnings for programmed doses and infusion rates in order to identify possible errors before medications or fluids are infused. Smart pumps also can help prevent potentially fatal over or underdosing and supply a wealth of infusion data for analysis to improve systems. 

However, many infusion errors continue to occur despite the use of smart pumps. This is due in part to organizations not fully engaging their inherent safety functionalities. Despite being extremely helpful, smart pumps also have some limitations that have yet to be fully addressed. Most significantly, they are often operated in isolation, and can’t interact with other available technology in hospitals to maximize safety. The good news is that many organizations are moving forward with plans to adopt smart pump interoperability with the electronic health record (EHR), so auto-programmingof the pump from the prescriber’s order and auto-documentation of IV therapy in the EHR can occur. 

Wireless connectivity of smart pumps, barcode scanning, and radio-frequency identification capabilities have laid the foundation for combining technologies that can further elevate smart infusion pumps’ ability to help prevent errors. The ultimate goal is to use these tools to provide real-time warnings, auto-programming and auto documentation, ongoing clinical surveillance, and an alert system that automatically flags any critical situation and communicates the information to the most appropriate healthcare provider. This will add a new dimension to IV infusion therapy safety.

The Institute for Safe Medication Practices (ISMP), an ECRI affiliate, has issued Guidelines for Optimizing Safe Implementation and Use of Smart Infusion Pumps to help hospitals better protect patients. To access a copy at no cost, visit ISMP’s website at As the leading nonprofit resource for independent and effective medication and patient safety recommendations, ISMP’s strategies are based on ongoing analysis of reports to the ISMP National Medication Errors Reporting Program and visits to healthcare organizations nationwide. ISMP has helped hospitals and other facilities optimize their use of technology and maximize patient safety.

In addition to recommendations for healthcare professionals, ISMP maintains a website for consumers,, that offers free information and resources on a wide range of medication safety issues from how to prevent errors during a hospital stay to avoiding prescription medication risks at home. 

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