Using Video to Describe the Patient-Controlled Analgesia Pump Programming Process: A Qualitative Study

Area of Science:

• Nursing Practice
• Medical Device Usability
• Patient Safety

Background:

• Patient-controlled analgesia (PCA) pumps are critical for postoperative pain management.
• Variations in PCA pump programming by nurses can result in medication errors.

Purpose of the Study:

• To identify and describe the similarities and differences in how surgical nurses program PCA pumps.
• To analyze the impact of PCA pump design on nursing workflow.

Main Methods:

• A qualitative study employing video reflexive ethnography (VRE) was conducted.
• Nurses were filmed programming PCA pumps; videos were analyzed by nursing leaders.

Main Results:

• Nurses frequently ignored or silenced alarms and exhibited uncertainty in programming sequences.
• Multiple interpretations of syringe loading and a misalignment between PCA pump design and nursing workflow were observed.
• Video reflexive ethnography effectively visualized common programming challenges.

Conclusions:

• VRE is a valuable tool for identifying challenges in PCA pump programming.
• Nursing leaders are initiating process changes based on the study's findings to improve patient safety.