A QI Project to Increase Nurses’ Use of ‘Smart’ Pump Libraries

By Sylvia Foley, AJN senior editor

In January 2009 an independent community hospital in Massachusetts switched from using older, outmoded IV pumps to using “smart” pumps—pumps that have built-in computers with libraries of information on selected drugs and fluids, including predetermined concentrations and volumes with relevant administration limits. Library subsets (called profiles) contain information specific to certain patient populations or care areas. When properly implemented, these devices can be invaluable tools in reducing the risk of medication errors and improving patient safety.

But when the hospital conducted a review, it found that smart pump libraries had been used in only 37% of all smart pump infusions done between January and June. One reason was that no “owner” had been assigned to oversee the implementation process. So the hospital’s nursing quality team (NQT) and pharmacy quality team began collaborating to find ways to increase nurses’ use of the pump libraries.

From July through October 2009 the NQT implemented several interventions. Author Andrew D. Harding describes the project as it evolved and reports on the results in this January CE feature, “Increasing the Use of ‘Smart’ Pump Libraries by Nurses: A Continuous Quality Improvement Project.” […]

2016-11-21T13:10:50-05:00February 1st, 2012|nursing perspective|1 Comment
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Upper-Extremity Deep Vein Thrombosis: How Clinicians at One Hospital Achieved Lower Rates

By Sylvia Foley, AJN senior editor

At a suburban hospital in Indiana, clinicians noticed that the incidence of secondary upper-extremity deep vein thrombosis (DVT) at their facility seemed to be on the rise. As Lancaster and colleagues report in the May Emergency, this was alarming: upper-extremity DVT, once thought benign, is now known to be potentially dangerous, leading to complications such as symptomatic or asymptomatic pulmonary embolism, chronic venous insufficiency, and postthrombotic syndrome. Secondary upper-extremity DVT, which accounts for a majority of cases, can be linked to an identifiable risk factor. Patients may present with pain, swelling, and bruising in the area of the thrombosis—but many patients show no symptoms. So it’s essential that nurses know which patients are at risk and how to minimize that risk.

The Indiana clinicians reviewed the literature to deepen their understanding. They also tracked all patients who underwent ultrasonography at their facility and conducted retrospective chart reviews, gathering data for a full year. Several new risk factors were identified, including

  • the use of the large veins at the antecubital fossa for peripheral IV access;
  • the use of harsh medications administered via peripheral IV; and
  • certain peripherally-inserted central catheter (PICC) flushing and care practices.

What they learned prompted several changes to nursing care, and the incidence of secondary upper-extremity DVT at this facility has since declined. To learn more about this quality improvement project and the changes that were implemented, read […]

2016-11-21T13:17:55-05:00April 30th, 2010|nursing perspective, nursing research|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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