Detecting Secondary Medication Infusion Errors via Spectrophotometry

Area of Science:

• Medical Devices
• Clinical Engineering
• Pharmacology

Background:

• Intravenous smart pumps (IVSPs) aim to minimize medication errors.
• Many IVSPs rely on hydrostatic head height differential (HHD) for secondary medication delivery.
• Poor clinical adherence to HHD requirements risks medication dilution and subtherapeutic dosing.

Purpose of the Study:

• To develop and validate a laboratory protocol for measuring delivered secondary medication concentration.
• To quantify the risk of medication dilution and underdelivery associated with different IVSP hanger configurations and flow rates.

Main Methods:

• A laboratory protocol was developed to measure delivered secondary medication concentration.
• Three hanger configurations (full, half, zero) were tested across various flow rates.
• Delivered concentrations were analyzed for accuracy and deviation from intended values.

Main Results:

• Both hanger configuration and programmed flow rate significantly impacted delivered concentration (P < 0.0001).
• Zero hanger configuration (zero HHD) resulted in severe underdelivery, often less than 50% of the intended concentration.
• Full and half hanger configurations maintained accuracy up to 250 mL/h, with decreased accuracy at 400 mL/h for the half hanger.

Conclusions:

• The study validated a method for direct measurement of secondary medication delivery accuracy.
• Clinical practice requires adherence to specific hanger configurations to ensure accurate medication delivery.
• Findings can inform safer clinical practices and future IVSP device development.