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Am J Health Syst Pharm. 2013 Nov 1;70(21):1897-906. doi: 10.2146/ajhp120767.

Impact of implementing smart infusion pumps in a pediatric intensive care unit.

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  • 1Silvia Manrique-Rodríguez, Pharm.D., Ph.D., is Clinical Hospital Pharmacist; Amelia C. Sánchez-Galindo, M.D., is Intensive Care Pediatrician; and Jesús López-Herce, M.D., Ph.D., is Intensive Care Pediatrician, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Miguel Ángel Calleja-Hernández, Pharm.D., Ph.D., is Director, Pharmacy Service, Hospital Universitario Virgen de las Nieves, Granada, Spain. Fernando Martínez-Martínez, Pharm.D., Ph.D., is University Professor, Faculty of Pharmacy, Campus de Cartuja, Granada. Irene Iglesias-Peinado, Pharm.D., Ph.D., is University Professor, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid. Ángel Carrillo-Álvarez, M.D., Ph.D., is Director, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón. María Sanjurjo Sáez, Pharm.D., is Director; and Cecilia M. Fernández-Llamazares, Pharm.D., Ph.D., is Clinical Hospital Pharmacist, Pharmacy Service, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón.



The impact of smart infusion pumps on the interception of errors in the programming of i.v. drug administrations on a pediatric intensive care unit (PICU) is investigated.


A prospective observational intervention study was conducted in the PICU of a hospital in Madrid, Spain, to estimate the patient safety benefits resulting from the implementation of smart pump technology (Alaris System, CareFusion, San Diego, CA). A systematic analysis of data stored by the devices during the designated study period (January 2010-June 2011) was conducted using the system software (Guardrails CQI Event Reporter, CareFusion). The severity of intercepted errors was independently classified by a group of four clinical pharmacists and a group of four intensive care pediatricians; analyses of intragroup and intergroup agreement in perceptions of severity were performed.


During the 17-month study period, the overall rate of user compliance with the safety software was 78%. The use of smart pump technology resulted in the interception of 92 programming errors, 84% of which involved analgesics, antiinfectives, inotropes, and sedatives. About 97% of the errors resulted from user programming of doses or infusion rates above the hard limits defined in the smart pump drug library. The potential consequences of the intercepted errors were considered to be of moderate, serious, or catastrophic severity in 49% of cases.


The use of smart pumps in a PICU improved patient safety by enabling the interception of infusion programming errors that posed the potential for severe injury to pediatric patients.

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