Smart pump features bar-coding for safer IVs

Cardinal Health has released a new software version for its Alaris System intravenous pumps, adding safety features and expanding the range of situations in which the pumps can be used.

"We've added the ability to really handle the oncology drugs," said Tim Vanderveen, Pharm.D., VP of the Cardinal Health Center for Medication Safety and Clinical Improvement. "We now have the ability to put in body surface area dosing so that the oncology units have the ability to use it. We put the guardrails not only around the potential dose but also around how fast you can give that drug."

The Alaris System competes in a growing market for the pump system devices. Pump makers are striving to achieve the "five rights" of drug delivery: the right drug for the right patient at the right dose and right time via the right route of administration. In all cases, device makers have sought to build pumps that evaluate the dosing regimens entered into the pumps. When a regimen conflicts with the recommended limits set by the hospital, the device alerts the user.

In addition to providing alerts to avoid complications, the pumps also record user actions, which, according to IOM's "Patient Safety: Achieving a New Standard for Care" report, "will become useful as sources of data on large numbers of near misses."

The latest version of the Alaris System also includes new modules for the administration of patient-controlled analgesia, integrating patient monitoring with the pump to suspend dosing of the drug in the event that respiratory rate falls below hospital-defined limits. The bar-coding functions of the pump can be integrated with existing hospital-wide bar-coding systems or be used independently.

The new system is already in place at Nebraska Medical Center in Omaha, a long-time Alaris user. Al Gould, clinical equipment specialist at the medical center, said that while older Alaris systems met most of the institution's needs, the promise of better-tailored solutions was attractive. "Having some additional levels of protection regarding chemotherapy doses is what motivated us to really get interested," he said.

Nebraska Medical Center began testing the new software in its oncology areas and expanded the system across the facility in October. "We thought this was definitely the right thing to do," Gould said. "It gave us an additional level of protection for chemotherapy as well as for selected antibiotics and selected IV fluids."

Gould explained that the staff at the medical center is still reviewing data from the early months of pump use. Past analyses with the older software suggested that use of the software could avert more than 200 errors a year.

According to Gould, the center will review cases where an end-user, such as an anesthesiologist or a nurse, received an alert from the system and, based on that alert, reprogrammed the device.

The user interface used to enter information into the pump and monitor medication status is similar to that of the existing Alaris system, and Gould said that with the exception of the PCA Alaris pumps-new equipment for the facility-no hands-on training was required for the upgrade.

THE AUTHOR is a writer based in Virginia.