Most intravenous infusion pumps are specified to deliver within +/- 5 % Is this the volume or flowrate accuracy ?
Most intravenous infusion pumps are specified to deliver within 5 % of flow setting, 10 % is acceptable for most applications ; for critical applications, the error should not exceed 5 % Inspection and Preventive Maintenance System 2001 ECRI. All Rights Reserved.
Air detection Sen. ( L ) Air Bubble Accumulation Setting Volume 25 L 0.83 mL 50 L 1.67 mL 100 L 3.33 mL 150 L 5.00 mL BAXTER Colleague
Infusion pump performance parameters
Good long term accuracy Good short term accuracy Rapid alarm after occlusion Small occlusion bolus Able to detect very small air embolus Small flow rate increments Good bolus accuracy Good long term accuracy Alarm after occlusion Small occlusion bolus Able to detect small air embolus Small flow rate increments Bolus accuracy Long term accuracy Alarm after occlusion Small occlusion bolus Able to detect small air embolus Increments flow rate
START is the patient a neonate ? Is a drug being delivered ? Is the drug diamorphine ? Is the patient volume sensitive ? The drug have a short half life or narrow therapeutic index ? A A B B C C N N N N N Y Y Y YY
First reported in the early 1990s by ISMP and the ECRI Institute, accidental, uncontrolled free- flow of IV solutions after removal of administration sets from infusion pumps was recognized as a serious problem that led to death and patient injury p - 22k - In the early 1990s
ECRI, issued a recommendation against purchasing any infusion device that dose not have a free flow protection built in to the administration sets In September 1992
FDA published an advisory with its own suggestions for preventing infusion-related errors. In 1994
JCAHO released a Sentinel Event Alert on infusion pump risks, noting that at least six deaths because of free-flow accidents. In November 2000
2003 JCAHO National Patient Safety Goals: Goal 5 : Improve the safety of infusion pumps Ensure free-flow protection on all general-use and PCA intravenous infusion pumps used in organization.
2003 JCAHO National Patient Safety Goals: Free-flow protection refer to a design in which the protection is built in to the administration set used with the pump
Infusion Pump Requirement Dropped from 2006 JCAHO National Patient Safety Goals:
IV set primed
Loaded in the infusion pump Infusion pump turn off
All the tubing clamps are opened
No fluid flows out of the set
Then removed the set from the device ( with all the tubing clamps still open )
.....no fluid flows out of the set ECRI Health Devices Inspection and Preventive Maintenance System
To avoid freeflow, fallow the manufacture ’ s recommendations and, whenever possible,count the drops in the drop chamber, to check the drip rate, before leaving the patient.
เอกสาร อ้างอิง 1. MDA : Medical Device Agency, Infusion Systems MDA DB 2003 ( 02 ) March Health Devices Inspection and Preventive Maintenance System, 2001 ECRI. 3. BAXTER Operator’s manual Colleague Volumetric Infusion Pump; 1996 – Environment of Care® News, November 2005, Volume 8, Issue 11 Copyright 2005 Joint Commission on Accreditation of Healthcare Organizations