Secondary Infusion Underdelivery: Risks and Rewards of Common Workarounds.

IF 1.5 Q2 NURSING
Jeannine W C Blake, Robert Butterfield, Tiffany Hopper, Nathaniel M Sims
{"title":"Secondary Infusion Underdelivery: Risks and Rewards of Common Workarounds.","authors":"Jeannine W C Blake, Robert Butterfield, Tiffany Hopper, Nathaniel M Sims","doi":"10.4037/aacnacc2025893","DOIUrl":null,"url":null,"abstract":"<p><p>Secondary medication delivery using large-volume smart pumps offers important workflow and safety benefits. However, the widely used linear peristaltic large-volume smart pumps rely on sufficient head-height differential for accurate secondary infusion, leading to underdelivery risks. This article outlines common clinician workarounds used to mitigate these risks, including delivering secondary medications via primary mode, programming excess volume to be infused, clamping primary lines, and using short-set primary delivery. Although intended to ensure full medication delivery, these strategies introduce safety risks, increase alert burden, and heighten cognitive load. In contrast, cassette-based large-volume smart pumps use valve-controlled fluid delivery, eliminating the need for head-height differential and reducing the potential for human error. This review evaluates the risks and rewards of these workarounds and offers guidance to support informed decision-making while advocating for long-term technology solutions that improve safety, reduce clinician burden, and align with best practices in infusion therapy.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"36 3","pages":"240-251"},"PeriodicalIF":1.5000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AACN Advanced Critical Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4037/aacnacc2025893","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0

Abstract

Secondary medication delivery using large-volume smart pumps offers important workflow and safety benefits. However, the widely used linear peristaltic large-volume smart pumps rely on sufficient head-height differential for accurate secondary infusion, leading to underdelivery risks. This article outlines common clinician workarounds used to mitigate these risks, including delivering secondary medications via primary mode, programming excess volume to be infused, clamping primary lines, and using short-set primary delivery. Although intended to ensure full medication delivery, these strategies introduce safety risks, increase alert burden, and heighten cognitive load. In contrast, cassette-based large-volume smart pumps use valve-controlled fluid delivery, eliminating the need for head-height differential and reducing the potential for human error. This review evaluates the risks and rewards of these workarounds and offers guidance to support informed decision-making while advocating for long-term technology solutions that improve safety, reduce clinician burden, and align with best practices in infusion therapy.

二次输液输送不足:常见解决方案的风险和回报。
使用大容量智能泵的二次药物输送提供了重要的工作流程和安全优势。然而,广泛使用的线性蠕动大容量智能泵依赖于足够的头部高度差来进行准确的二次输液,导致输送不足的风险。本文概述了临床医生常用的缓解这些风险的方法,包括通过初级模式提供二级药物,规划过量的输注量,固定初级输注线,以及使用短时间的初级输注。尽管这些策略旨在确保充分的药物递送,但它们带来了安全风险,增加了警觉负担,并增加了认知负荷。相比之下,基于盒式的大容量智能泵使用阀控流体输送,消除了对水头高度差的需求,减少了人为错误的可能性。本综述评估了这些变通方法的风险和回报,并为支持明智的决策提供指导,同时倡导长期的技术解决方案,以提高安全性,减轻临床医生的负担,并与输液治疗的最佳实践保持一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.10
自引率
4.50%
发文量
37
期刊介绍: AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue. AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信