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Published on: February 16, 2017
Using Video to Describe the Patient-Controlled Analgesia Pump Programming Process: A Qualitative Study
Milisa Manojlovich1, Katie Barwig, Jember Bekele
1School of Nursing, University of Michigan, Ann Arbor (Drs Manojlovich and Ali Charania); Von Voigtlander Women's Hospital (Dr Bradshaw), and Surgical Services and PM&R, Pain Service (Ms Lundy), University of Michigan Health, Ann Arbor (Mss Barwig, Bekele, and Streelman).
Background:
Patient-controlled analgesia (PCA) pumps are complex medical devices frequently used for postoperative pain control. Differences in how nurses program PCA pumps can lead to preventable medication errors.
Purpose:
To describe similarities and differences in how surgical nurses program PCA pumps.
Methods:
We conducted a qualitative study using video reflexive ethnography (VRE) to film nurses as they programmed a PCA pump. We spliced and collated videos into separate clips and showed to nursing leaders for their deliberation and action.
Results:
We found nurses ignored or immediately silenced alarms, were uncertain about the correct programming sequence, and interpreted how to load a syringe in the pump in multiple ways; in addition, the PCA pump design did not align with nurses' workflow.
Conclusions:
VRE was effective in visualizing common challenges nurses experienced during PCA pump programming. Nursing leaders are planning several nursing process changes due to these findings.
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