Syringe Infusion Pumps: A Comprehensive Overview and Considerations for Use at Low Delivery Rates

ACPE Activity Number:  0204-0000-20-429-H05-P
Activity Date: November 2, 2020
Expiration Date: November 1, 2023
Activity Type: Application-based 
CE Credits: 1.5 hour
Activity Fee:Free of charge

Accreditation for Pharmacists

The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Accreditation for Physicians

The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Society of Health-System Pharmacists designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accreditation for Nurses

This nursing continuing professional development activity was approved by the Maryland Nurses Association, which is an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Target Audience

This activity was planned to meet the educational needs of pharmacists, physicians, nurses, physician assistants, and nurse practitioners with an interest in syringe pumps and patient safety.

Activity Overview

The Food and Drug Administration’s national safety communication on syringe pumps brought renewed attention to the serious consequences of their incorrect use and the need for clinicians to better understand their limitations. Syringe pumps permit the delivery of concentrated, rapid acting intravenous medications at slow infusion rates and provide a means to deliver multiple medications in the face of conservative fluid management.   

This course begins by exploring the principles on which syringe systems operate. This reveals nuances of their operation that may lead to unexpected medication delivery. The course concludes with a discussion of best practices for ensuring the desired infusion. This includes adopting ASHP’s Standardize4Safety recommendations, optimizing dispensing practices and syringe size selection, and developing protocols for syringe change-over. Applying this knowledge will help clinicians use syringe pumps in a manner that ensures patients receive their medication in a timely, stable, and continuous manner.

Learning Objectives

At the conclusion of this activity, participants should be able to

  • Describe the mechanics and physics of smart syringe infusion systems, including the pumps, syringe, and disposables, and their impact on clinical performance.
  • Explain appropriate methods for supporting the optimal, balanced selection of medication concentrations and syringe sizes, and for loading, priming, and safely changing-over continuous running infusions.
  • Identify best practices for optimizing flow stability and uniformity. 

Faculty Information

Nathaniel M. Sims, M.D.

Research Faculty, Department of Anesthesia, Critical Care, and Pain Medicine
Massachusetts General Hospital
Associate Professor, Anesthesiology
Harvard Medical School
Boston, Massachusetts

Nathaniel Sims, M.D. is Associate Professor of Anesthesia at Harvard Medical School, Physician Advisor to Biomedical Engineering at Massachusetts General Hospital (MGH), and the Ronald S. Newbower, Ph.D. MGH Endowed Chair in Biomedical Technology Innovation in Boston, Massachusetts. 

Over a forty-year career at MGH, Dr. Sims, a cardiac anesthesiologist, has developed numerous technologies to make patient care safer and more efficient while reducing cost. Dr. Sims and his colleagues at MGH have pioneered improvements in patient monitoring, patient transport, and error-free intravenous drug delivery systems. Dr. Sims developed the original concepts for “smart drug infusion pumps” in 1992, is the lead inventor on U.S. Pat. No. 5,681,285, “Infusion pump with an electronically loadable drug library and a user interface for loading the library”, and he implemented this invention clinically at MGH in 1997. Dr. Sims holds multiple U.S. patents and has used licensing revenues for the advancement of medical technology innovation and patient safety. He is a member of the Association for the Advancement of Medical Instrumentation (AAMI) Infusion Device standards committee and has special expertise in fluid flow rate testing of drug infusion pumps, including the development of new methods for such testing.

Kimberly Whalen, R.N., M.S., CCRN
Nursing Practice Specialist
Massachusetts General Hospital
Boston, Massachusetts

Kimberly Whalen, R.N., M.S., CCRN is Nursing Practice Specialist in the Pediatric Intensive Care Unit at Massachusetts General Hospital (MGH) in Boston, Massachusetts, where she has 24 years’ experience as a Pediatric Intensive Care nurse. 

Ms. Whalen received her master’s in nursing informatics and was the pediatric informatics analyst at MGH for two years during the transition to Epic. She worked with the Partners Informatics team and published research on the transition for pediatrics and nursing clinical decision support. She has also taught simulation and pediatric clinicals at various universities. 

Ms. Whalen serves on the ASHP Pediatric Standardize4Safety Continuous Infusion Expert Panel and as an Affiliated Member of the American Academy of Pediatrics Council of Clinical Information Technology. She maintains board certification for Critical Care Registered Nurse and Trauma Nurse Certification. She is also a part of the Regional Biothreats Team at MGH. 

Ms. Whalen promotes and is and advocate for nursing innovation and holds a device patent. She is a published author and has spoken and presented at many national conferences. Her career has combined pediatric critical care, teaching, innovation and informatics to provide evidence-based practice to the vulnerable population of pediatrics.

Sylvia Okrzesik, Pharm.D., BCPPS
Pediatric Clinical Pharmacist- PICU/NICU/ED
Massachusetts General Hospital
Coordinator, Longitudinal Advanced Pharmacy Practice (LAPP) Program
Boston, Massachusetts

Sylvia A. Okrzesik, Pharm.D., BCPPS is Pediatric Clinical Pharmacist- PICU/Pediatric ED/ NICU and Coordinator, Longitudinal Advanced Pharmacy Practice at Massachusetts General Hospital (MGH) in Boston, Massachusetts. 

Dr. Okrzesik earned her Doctor of Pharmacy degree from Notre Dame of Maryland University in Baltimore, Maryland. She completed her ASHP-accredited PGY-1 residency at Baystate Medical Center in Springfield, Massachusetts. She went on to pursue an ASHP-accredited PGY-2 residency in pediatrics at the University of California San Francisco in San Francisco, California where she stayed on as the Pediatric Oncology/Bone Marrow Transplant pharmacist prior to pursuing a career in her current position. 

Dr. Okrzesik covers the Pediatric and Neonatal Intensive Care Units (PICU//NICU) as well as the Pediatric Emergency Department at MGH. She serves as a preceptor for postgraduate year 1 (PGY-1) residents that rotate through the PICU or NICU. She also precepts the postgraduate year 2 (PGY-2) critical care and emergency medicine residents that rotate in the PICU and Pediatric Emergency Department. In addition to her clinical services, Dr. Okrzesik serves as adjunct faculty for two colleges of pharmacy in Massachusetts: Northeastern University and Massachusetts College of Pharmacy and Health

Sciences (MCPHS). She is one of the Coordinators for the Northeastern University Longitudinal Advanced Pharmacy Practice Experience. 

Dr. Okrzesik is a board-certified in pediatric pharmacotherapy. She is involved in several committees within her institution to enhance medication safety in the pediatric and neonatal population and serves as an active member in multi-disciplinary committees for her clinical specialty areas.

Christopher Colvin, MHSc
Clinical Engineer
Massachusetts General Hospital
Boston, Massachusetts
Healthcare Human Factors & Instructional Design Consultant
Toronto, Ontario, Canada

Christopher Colvin, MHSc, is a clinical engineer working to improve patient care through the application of engineering, human factors, and instructional design principles. 

Mr. Colvin received his Masters of Health Science in Clinical Engineering from the University of Toronto, Canada, and a Bachelor of Engineering in Biological Engineering from the University of Guelph, Canada. 

Mr. Colvin has worked with Massachusetts General Hospital and the Toronto University Health Network to perform research and quality improvement activities aimed at promoting a better understanding of healthcare technologies and practices. This has included human factors testing of medical devices, anesthesia management research, and development of a wide portfolio of educational content. He has developed online courses on topics such as medical device utilization, anesthesia monitoring practices, and infusion safety. As an instructional designer, Mr. Colvin leverages his multimedia design skill and understanding of adult learning principles to support the teaching of complex technical topics through graphic, animated, and interactive content.

 

Disclosures

In accordance with ACCME and ACPE Standards for Commercial Support, ASHP policy requires that all faculty, planners, reviewers, staff, and others in a position to control the content of this presentation disclose their financial relationships.  In this activity, no persons associated with this activity have disclosed any relevant financial relationships.

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System Technical Requirements

This is an online activity consisting of slides with audio and pretest and posttest assessments. View the system requirements.

Provided by ASHP
Supported by an educational grant from Baxter Healthcare Corporation