Modern Trends in Nursing: The Alaris Pump and The Pneumatic Tube System

Introduction

Technology is rapidly changing and evolving in the healthcare setting. In the Intensive Care Unit (ICU) technology is especially important as nurses must manage extremely sick patients. Technology advancement can help cut costs, improve outcomes, streamline workflow, and facilitate the accessibility of information (Huston, 2019). In the Intelligent Hospital Pavilion videos, many different technologies are showcased to demonstrate how they can be implemented into hospitals with an emphasis in the ICU, and how this technology has an impact on workflow and patient safety. In the video, I found the Alaris pump and the pneumatic tube system as beneficial technologies not only for patients but for the nurses as well. However, with any technology, there are always risks that need to be considered. This paper will discuss the benefits and risks of the Alaris pump and the pneumatic tube system and why I support this technology.

Benefits of the Alaris pump and the pneumatic tube system

In the ICU setting, nurses must start many different infusions at the same time to keep their patients alive, such as vasopressors and fluids, which is one of the reasons hospitals have moved to use smart pumps, such as the Alaris pump. These pumps are used for intravenous infusions for nutrients, medications, and fluids and have drug libraries and dose error reduction systems installed in them for safety (Giuliano, 2015). The main benefit of these pumps is preventing medication errors. Due to the safeguards programmed into these pumps, it protects patients and nurses in case nurses were to accidentally input the wrong dosage information into the pump. Nurses no longer have to do medication calculations preventing them from confusion and mistakes because the built-in drug libraries allow nurses to choose the medication by inputting the required patient information and then the pump calculates the infusion rate for the nurse (Giuliano, 2015). Other benefits include pump alarms, which alert nurses that something is wrong and allows patients to be proactive with their care. These pumps are designed to alert if there is a blockage or air in the tubing, if the infusion is completed, or if the infusion has not started in a primary line, all safeguards for patients and nurses (FDA, 2018). Once these alarms are heard nurses go into their patient’s room to fix the error or patients call their nurse due to the constant alarm.

Another difficulty of being in the ICU includes having to send labs out quickly to properly treat patients in emergencies and receiving necessary medications from the pharmacy. The Intelligent Hospital Pavilion video showcased another technology that also has many benefits in the hospital known as the pneumatic tube system. Normally, in the ICU nurses collect specimens and must take them directly to the laboratory or wait for someone to pick them up. This practice removes nurses from their critical patients and increases wait times for critical labs. According to Kapoula et al. (2017), the pneumatic tube system reduces laboratory turnaround time and due to the specimen being sent directly to the lab from the hospital unit it allows nurses to focus on patient care activities. Dr. Neil Halpern further states that the pneumatic tube system provides immediate tracking information for the ICU staff detailing when necessary items arrive in the ICU or when they arrive at their destination. This technology allows ICU nurses to provide quality care in a timely manner and increases the service quality of the hospital.

Risks of the Alaris pump and the pneumatic tube system

It is important to recognize that with new technology there are also risks involved. To start the Alaris pump is not updated often, causing nurses to program fluids and medications without the safeguards leaving room for error. Research has shown that adverse drug events are related to incorrect or incomplete programming, especially when it comes to administering secondary line medications as the pumps are unable to determine whether the medication is running or not (Kapoula, 2017). Due to the Alaris pump doing all the work, nurses use their critical thinking skills less and less when administering medications which can also cause a potential error. For example, the pump could potentially malfunction or have the incorrect infusion rate programmed and the nurse may bypass safety checks causing a medication error. The FDA (2018) stated, that although user error can occur “the most common types of reported problems have been associated with software defects, user interface issues, and mechanical and electrical issues”. These errors can occur if nurses solely rely on the technology that is in place to assist them.

Regarding the pneumatic tube system, the main risk due to research arises from the configuration of the system. The pneumatic tube system works by sending cylindrical containers through networks of tubes by compressed air or by partial vacuum (Woodford, 2019). Many samples are sent through this transport system especially blood samples that can be altered due to the “forces of pressure such as sudden accelerations/decelerations, high speeds, changes in air pressure generated by the vacuum system, [and] movement of blood in test tubes and vibrations” (Kapoula et al., 2017). Unfortunately, the forces subjected on the samples, especially blood samples can lead to common error from hemolysis and also deem the samples unusable. This error causes a delay in patient care causing patient's lives to be at risk and nurses having to do double the work.

Opinion/ Conclusion

Through my clinical experience, I have been able to use both the Alaris pump and the pneumatic tube system and have have been able to see firsthand the benefits of these technologies. Although I still think there are definite risks, using the Alaris pump and the pneumatic tube system has proven to have more beneficial qualities than negative. According to a study conducted by Van der Sluijs et al. (2019), the use of Alaris pumps has been able to reduce medication errors rates from 17.7% to 2.3% in the ICU. This percentage from this study attests that smart pumps work and are a technology that is keeping patients safe. Regarding the pneumatic tube system, a study showed that out of 15,851 blood specimens that were transported via a pneumatic tube system and 92 samples that were hand-delivered, the number of proportions of hemolyzed specimens in the two groups were not significantly different, showing promising statistics that this technology is beneficial to our patients (Phelan et al., 2016). In conclusion, I support the use of these technologies in hospitals, keeping in mind that improvements are always necessary. The technology discussed in this paper has proven to provide faster care and better clinical outcomes and with proper use and critical thinking from the user, technology can continue to shape the future of health care.

References

• Giuliano K. K. (2015). IV Smart Pumps: The Impact of a Simplified User Interface on Clinical Use. Biomedical instrumentation & technology, Suppl, 13–21. https://doi.org/10.2345/0899-8205-49.s4.13
• Huston, C.J. (2019). Professional Issues in Nursing: Challenges and opportunities (5th edition).
• Kapoula, G., Kontou, P. & Bagos, P. (2017). The impact of pneumatic tube system on routine laboratory parameters: a systematic review and meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM), 55(12), pp. 1834-1844. Retrieved 16 Mar. 2020, from doi:10.1515/cclm-2017-0008
• Phelan, M. P., Reineks, E. Z., Hustey, F. M., Berriochoa, J. P., Podolsky, S. R., Meldon, S., Schold, J. D., Chamberlin, J., & Procop, G. W. (2016). Does Pneumatic Tube System Transport Contribute to Hemolysis in ED Blood Samples?. The western journal of emergency medicine, 17(5), 557–560. https://doi.org/10.5811/westjem.2016.6.29948
• U.S. Food and Drug Administration (FDA). (2018). Infusion Pumps. Retrieved from https://www.fda.gov/medical-devices/general-hospital-devices-and-supplies/infusion-pumps
• Van der Sluijs, A. F., van Slobbe-Bijlsma, E. R., Goossens, A., Vlaar, A. P., & Dongelmans, D. A. (2019). Reducing errors in the administration of medication with infusion pumps in the intensive care department: A lean approach. SAGE open medicine, 7, 2050312118822629. https://doi.org/10.1177/2050312118822629
• Woodford, C. (2019). Pneumatic tube transport. Retrieved from https://www.explainthatstuff.com/pneumatic-tube-transport.html