Enhancing IV Smart Pump Setup and Flow Rate Accuracy: An Exploratory Study on an Educational Intervention in Critical Care

Author Department

Nursing

Document Type

Article, Peer-reviewed

Publication Date

2026

Abstract

Background:

Large-volume intravenous (IV) smart pumps (IVSP) are crucial for IV medication administration in acute and critical care. The Dose Error Reduction System (DERS) helps prevent dosing errors but does not address actual versus programmed flow rate discrepancies, which are influenced by various clinical and technical factors.

Aim:

This study aimed to (1) observe adherence to manufacturer setup requirements and IV flow rate accuracy, (2) implement an educational program for critical care nurses, and (3) reassess adherence and accuracy post-education.

Methods:

Observations were collected in critically ill patients in two phases: 25 before and 25 after the educational program. The program was delivered during staff meetings and via recorded sessions, focusing on manufacturer-required setup for head-height dependent IVSP.

Results/Findings:

Key findings included improved compliance with unclamped secondary tubing (72.7% pre-education vs. 91.7% post-education) and increased use of back-check valves (93.1% vs. 99.0%). Median absolute flow rate deviations decreased from 2.0 mL/hr to 1.3 mL/hr for primary infusions and from 6.0 mL/hr to 4.0 mL/hr for secondary infusions.

Conclusions:

The educational program improved certain setup practices, but overall compliance remained suboptimal. Future research should include a larger sample size and consider additional clinical factors affecting IV flow rate accuracy.

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