Intravenous chemotherapy administration using smart infusion pumps
Abstract:
Objective: To standardise intravenous antineoplastic administration and reduce administration-phase discrepancies by implementing parameterised smart infusion pumps supported by a clinical pharmacist- governed drug library.
Data Sources: Pump alert logs and structured clinical pharmacist records of administration discrepancies collected during routine care over 12 months following go-live.
Data Summary: Chemotherapy administration is vulnerable to wrong infusion duration/rate selection and missed drug-specific requirements (e.g., in-line filters and light protection). A multidisciplinary team implemented parameterised smart infusion pumps with a structured library requiring selection of the exact antineoplastic agent prior to infusion. For each agent, validated infusion-time windows were mapped to safe rate ranges and enforced as locked hard limits; mandatory prompts highlighted filter and light-protection requirements where applicable. Clinical pharmacists led drug-library build, validation and change control with oncology/haematology physicians and nursing leadership, supported by staff training and standardised workflow aids. During the 12-month evaluation period, approximately 17,000 chemotherapy days and 40,000 chemotherapy infusions were assessed. Smart pump safeguards identified and enabled correction of 26 near-miss administration discrepancies before infusion initiation, corresponding to 0.15 discrepancies per 100 chemotherapy days. Parameterisation reduced programming steps and shortened set-up time by approximately 30 s per infusion, corresponding to an estimated net nursing time saving of around one hour per day.
Conclusions: A clinical pharmacist-led parameterised smart pump programme strengthened standardisation at the point of administration and supported a proactive medication-safety culture in routine practice. This practice-based report provides transferable operational detail on governance and bedside safeguards for oncology pharmacy services.
Reference:
Ioannidis K, Scarlatinis I, Nikolaou K. Enhancing intravenous chemotherapy administration safety using parameterised smart infusion pumps: A one-year practice implementation. J Oncol Pharm Pract. 2026 Sep 7:10781552261486712. doi: 10.1177/10781552261486712. Epub ahead of print. PMID: 42706594.