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GUIDELINES Infusion pumps, used to deliver fluids into a client’s body in a controlled manner, are used extensively in health care, including in the home environment, and are associated with significant safety issues and harm to clients. This ROP focuses on parenteral delivery (i.e., routes other than the digestive tract or topical application) of fluids, medications, blood and blood products, and nutrients. It includes stationary and mobile intravenous infusion pumps, patient-controlled analgesia, epidural pumps, insulin pumps, and large-volume pumps. It excludes gastric feeding pumps. Team members need training and education to maintain their competence in using infusion pumps safely, given the variety of pump types and manufacturers, the movement of team members between services, and the use of temporary staff. Safety is best achieved when organizations have a comprehensive approach that combines training and evaluation with the appropriate selection, procurement, and standardization of infusion pumps across an organization (see Accreditation Canada standards for medication management). When evaluations reveal problems with infusion pump design, organizations can work with manufacturers to make improvements. Organizations are encouraged to report problems externally (e.g., to Health Canada or Global Patient Safety Alerts) so that other organizations can implement safety improvements. TESTS FOR COMPLIANCE Major Instructions and user guides for each type of infusion pump are easily accessible at all times. Major Initial and re-training on the safe use of infusion pumps is provided to team members: Who are new to the organization or temporary staff new to the service area Who are returning after an extended leave When a new type of infusion pump is introduced or when existing infusion pumps are upgraded When evaluation of competence indicates that re-training is needed When infusion pumps are used very infrequently, just-in-time training is provided. Major When clients are provided with client-operated infusion pumps (e.g., patient-controlled analgesia, insulin pumps), training is provided, and documented, to clients and families on how to use them safely. Major The competence of team members to use infusion pumps safely is evaluated and documented at least every two years. When infusion pumps are used very infrequently, a just-in-time evaluation of competence is performed.
REQUIRED ORGANIZATIONAL PRACTICES 2016accreditation.ca | 48 Minor The effectiveness of the approach is evaluated. Evaluation mechanisms may include: Investigating patient safety incidents related to infusion pump use Reviewing data from smart pumps Monitoring evaluations of competence Seeking feedback from clients, families, and team members Minor When evaluations of infusion pump safety indicate improvements are needed, training is improved or adjustments are made to infusion pumps.