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RISKS IN THE IMPLEMENTATION AND USE OF SMART PUMPS IN A PEDIATRIC INTENSIVE CARE UNIT: APPLICATION OF THE FAILURE MODE AND EFFECTS ANALYSIS

Published online by Cambridge University Press:  28 April 2014

Silvia Manrique-Rodríguez ,
Amelia C Sánchez-Galindo ,
Jesús López-Herce ,
Miguel Ángel Calleja-Hernández ,
Irene Iglesias-Peinado ,
Ángel Carrillo-Álvarez ,
María Sanjurjo Sáez  and
Cecilia M Fernández-Llamazares
Silvia Manrique-Rodríguez
Affiliation:
Pharmacy Service, Gregorio Marañón University Hospital
Amelia C Sánchez-Galindo
Affiliation:
Pediatric Intensive Care Unit, Gregorio Marañón University Hospital
Jesús López-Herce
Affiliation:
Pediatric Intensive Care Unit, Gregorio Marañón University Hospital
Miguel Ángel Calleja-Hernández
Affiliation:
Pharmacy Service, Virgen de las Nieves University Hospital
Irene Iglesias-Peinado
Affiliation:
Faculty of Pharmacy, Complutense University of Madrid, Ciudad Universitaria
Ángel Carrillo-Álvarez
Affiliation:
Pediatric Intensive Care Unit, Gregorio Marañón University Hospital
María Sanjurjo Sáez
Affiliation:
Pharmacy Service, Gregorio Marañón University Hospital
Cecilia M Fernández-Llamazares
Affiliation:
Pharmacy Service, Gregorio Marañón University Hospital
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Abstract

Objectives: The aim of this study was to identify risk points in the different stages of the smart infusion pump implementation process to prioritize improvement measures.

Methods: Failure modes and effects analysis (FMEA) in the pediatric intensive care unit (PICU) of a General and Teaching Hospital. A multidisciplinary team was comprised of two intensive care pediatricians, two clinical pharmacists and the PICU nurse manager. FMEA was carried out before implementing CareFusion infusion smart pumps and eighteen months after to identify risk points during three different stages of the implementation process: creating a drug library; using the technology during clinical practice and analyzing the data stored using Guardrails® CQI v4.1 Event Reporter software.

Results: Several actions for improvement were taken. These included carrying out periodical reviews of the drug library, developing support documents, and including a training profile in the system so that alarms set off by real programming errors could be distinguished from those caused by incorrect use of the system. Eighteen months after the implementation, these measures had helped to reduce the likelihood of each risk point occurring and increase the likelihood of their detection.

Conclusions: Carrying out an FMEA made it possible to detect risk points in the use of smart pumps, take action to improve the tool, and adapt it to the PICU. Providing user training and support tools and continuously monitoring results helped to improve the usefulness of the drug library, increased users’ compliance with the drug library, and decreased the number of unnecessary alarms.

Keywords

FMEASmart pumpsPediatric intensive careSafety
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 2 , April 2014 , pp. 210 - 217
Copyright
Copyright © Cambridge University Press 2014 

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