Evaluating IV smart pump infusions and alarms in health systems across the United States

Intravenous smart pumps (IVSPs) are designed to safely and accurately deliver IV medications to patients. IVSP programming alerts are relatively well understood; however, little is known about IVSP alarms, their contribution to alarm fatigue, and how to minimize unnecessary ones. The purpose of this study was to describe the volume, frequency, and types of IVSP infusions and alarms that occurred over a 2-year period in 107 US hospitals.

A retrospective, descriptive analysis of a large-scale dataset containing IVSP infusion and alarm data was conducted. Additional variables, such as patient population, medication name, medication class, infusion type, and infusion duration were included in the analysis.

More than 62 million infusions and 65 million alarms were analyzed. Approximately 30% of all infusions involved 1 or more alarms. Overall, there were an average of 1.06 alarms per infusion; for infusions with at least 1 alarm, there were 3.51 alarms per infusion. The top 4 alarm types accounted for 81.8% of all alarms. Antineoplastic agents, blood derivatives, local anesthetics, and immunomodulatory agents each had a higher-than-average percentage of infusions with at least 1 alarm, as did patient-controlled analgesia (PCA)-administered infusions. Monoclonal antibodies had a much higher-than-average number of "bolus air in line" alarms, specifically. A higher number of alarms was also observed for infusions of longer duration.

This study provides valuable insights into the prevalence and characteristics of IVSP infusions and alarms. Key patterns in alarm frequency and alarm type and association between alarms and key infusion characteristics are also highlighted. These findings can inform efforts to optimize IVSP alarm management and decrease their contribution to alarm fatigue.