Archive March 2017 XVIII, No. 3

Ideas That Work: Tried-and-True Ways to Avoid IV Infusion Errors

examine the pump ALL SYSTEMS GO Before starting an infusion, examine the pump for signs of physical damage, says Ms. Sparnon.

Tried-and-True Ways to Avoid IV Infusion Errors

Anesthesia providers and nurses can help reduce infusion errors, and prevent harm when errors do occur, by following 3 simple practices. Once commonplace, these practices are now often overlooked — perhaps because staff implicitly trust the pump's advanced safety features.

  • Check the drip chamber. After setting up an infusion, look at the drip chamber beneath the medication reservoir to see if the infusion rate matches what you think you've programmed. This can help identify gross programming errors and uncontrolled flow of medication to the patient, known as "IV free flow" — which can lead to patient harm and even death. If you haven't done this in a while, consider running a pump at 10, 100, and 1,000 mL/hour to get a sense for what these flow rates look like.
  • Use the manual roller clamp. Every time you remove the set from the pump, use the manual roller clamp on the IV tubing to close off the set. This prevents flow in the rare event that the set-based free-flow protection is defeated or doesn't properly engage.
  • Inspect the pump for damage. Before starting an infusion, examine the pump. If you see cracks in the housing, or if a door isn't seating properly, or if it takes more force than usual to close a door, the pump may not operate properly. Use a different pump and send the broken one for repair.

Erin Sparnon, MEng
ECRI Institute
Plymouth Meeting, Pa.

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