The COVID-19 pandemic forced us to adapt and change from care as usual to thinking outside the box—or in the case of Montefiore Medical Center in the Bronx, New York, outside the room.

Our February CE feature, “Using Smart IV Infusion Pumps Outside of Patient Rooms,” describes an innovation that helped save three valuable commodities that were at risk early in the pandemic—staff’s health, time, and PPE.

Administering medication and IV fluids can be very time-consuming, especially when nurses are required to don and doff a mask and isolation gown every time they enter and exit the patient’s room. However, keeping the IV infusion pump outside of the room makes it accessible in the hallway and eliminates the need for isolation precautions.

Considerations with use of this approach.

The authors recognize that one major concern with having the IV pump outside of the room is the decreased frequency of IV patient assessment. They note, “Standards were modified to allow staff to assess IV sites for dressing integrity and infiltration during the repositioning of prone patients, whose heads needed to be turned every two hours.” And “[i]f a patient’s change in condition coincided with the use of additional extension sets and the relocation of the pump, staff were instructed to eliminate the extra tubing and return the pump to the bedside.”

Of course, there are details to consider in order to make it safe and effective for the patient. The authors based these decisions on information gathered from searching the extant literature (of which there was very little on the topic), information shared by health care workers on social media, and consulting IV pump manufacturer guidelines.

Some of these considerations were:

  • determining criteria for patients who can safely have the IV pump outside of the room
  • a method for patient identification to ensure the right patient was getting the right medication
  • determining where to place elongated IV tubing, such as on the floor, hooked to the walls or ceiling, or under the room door
  • choosing equipment that ensures correct rate flow when pressures are changed due to longer than usual IV tubing
  • determining correct flushing volumes

If you think your facility can benefit from this practice, be sure to read the full article where the authors provide the details of how they managed these concerns and more.

CE credit is available with this article, which is currently free in our February issue.