Useful reports/documents on IV Administration Sets and Pump
Scottish report on IV systems.
The Scottish Office Home and Health Department published a report in October 1995 onÂ "The Management of Infusion Systems". The report makes recommendations on the safe use of infusion systems (i.e., IV pumps and syringe drivers) throughout the UK, covering such diverse matters as the management of infusion systems, procurement policies, installation, training, maintenance and repair, documentation, and adverse incident reporting and safety warnings.
Some of the key recommendations are as follows:
- A named individual should be designated Device Manager for each clearly identifiable unit.
- Multidisciplinary device committees should be considered in larger organisations to provide inter-departmental consensus advice regarding procurement policies, operational guidelines, documentation and monitoring/audit.
- All devices should be subject to the same procurement policy, which should be documented.
- The number of different models in use within a unit should be minimised as far as possible.
- All short-listed items should be evaluated on site wherever possible.
- All units should develop and maintain comprehensive device registers.
- Training and practical instruction as well as familiarity with devices should be addressed as a matter of urgency by those responsible for education. The principles in the Health Equipment Information bulletin HEI 98 should be followed, in particular the statement thatÂ "those unfamiliar with equipment should be forbidden to operate it unless supervised or until they are considered competent in its use".
- A clear system for dealing with damaged devices should be established, including procedures for withdrawing devices from use and re-introducing devices into use.
- Local drug and therapeutic committees should work together to produce clinical guidelines on the safe prescribing and administration of drugs by the use of infusion systems in hospital and community settings.
- For each infusion, a record should be made of the required time interval for checking.
- Discharge plans must provide relevant information to the patient/carer and anyone else involved in the patient's treatment.
Copies of the full report are available from the Department of Health, PO Box 410, Wetherby, LS23 7LL, United Kingdom.
Also available as an MDA device bulletin - seeÂ "DB 9504 The management of infusion systems - A report by the Scottish Home Office and Health Department. November 1995." Copies from the Medical Devices Agency - seeÂ
Device Bulletin on Infusion Systems.
The MDA Device BulletinÂ MDA DB 9503, May 1995 addresses the use and selection of infusion systems, including their potential risks and advantages. The advice is aimed at clinical managers and to others involved in the care of patients, with the aim of reducing the number of adverse incidents arising from their use.
The report starts with an overview which explains the differences between gravity controllers (drip-rate and volumetric) and infusion pumps (drip-rate pumps, volumetric pumps, syringe-drivers, PCA pumps, and other devices). This is followed by a section on the risks and applications of each of these types of device, where the specific disadvantages and advantages of each device is listed. The classification scheme ofÂ Neonatal, High Risk, and Lower Risk is explained followed by advice on the aspects to be considered when choosing an infusions system to use.
General safety recommendations are covered, including advice on free-flow, air entrainment and the use of blood sets and solution sets. Purchasing policies and management aspects conclude the main report.
The appendices will be a useful source of information to everyone involved in this field. Appendix I gives recommendations for infusion devices classified by Type. For example, you can determine what the occlusion pressure at 1ml/h should be in a syringe pump for neonatal use (less than or equal to 300mmHg), or the recommended time to alarm following occlusion at 1ml/h for a volumetric pump bein used in a high risk infusion (less than or equal to 45 minutes).
Copies from the Medical Devices Agency - seeÂ www.mhra.gov.uk for further information.
ECRI guide to infusion pumps.
ECRI Health Technology Monitor, Vol 3, No 4 (April 1997), has as its lead article a purchasing guide to general purpose infusion pumps.
The guide covers the current state of technology, special features found on IV pumps, pump selection considerations and cost alayses.