Over 65 million infusion pump alarms analyzed
Abstract:
Purpose: Alarm fatigue is a serious problem in hospitals, often affecting nurses’ concentration and increasing the risk of patient harm. Alarms associated with intravenous smart pumps (IVSPs) contribute to alarm fatigue; however, little is known about what causes unnecessary IVSP alarms or how to reduce them. The purpose of this study is to explore variables that impact the type and number of IVSP alarms and to demonstrate how alarm data can be used to identify IVSP alarm problem areas to target for improvement.
Methods: A dataset containing IVSP infusion and alarm data for 62 million infusions from 107 US hospitals over a 24-month period was analyzed. Detailed analyses on the types and frequency of IVSP alarms for medication classes and select medications were performed.
Results: Over 65 million alarms were analyzed. Infusions of antibacterials generated a higher percentage of “Door Open” and “Bolus Air in Line” alarms than were generated in the all-infusion sample. Central nervous system (CNS) agents had fewer “Patient Side Occlusion” alarms, and opioid agonists generated more patient-controlled analgesia-related alarms. Antineoplastic agents, monoclonal antibodies, and agents for blood formation, coagulation, and thrombosis all had a high ratio of alarms to infusions with alarms. Antineoplastic agents and monoclonal antibodies generated a high percentage of Bolus Air in Line alarms, and agents for blood formation, coagulation, and thrombosis (ie, heparin) had more Patient Side Occlusion alarms.
Conclusion: This study demonstrates how IVSP alarm data, when evaluated by medication class or individual medication(s), can be used to identify potential areas to target for reducing unnecessary IVSP alarms.
Reference:
Armistead LT, Giuliano KK, Degnan D, Eckel SF. Exploring the impact of medication type and infusion duration on IV smart pump alarms. Am J Health Syst Pharm. 2026 Mar 10:zxag076. doi: 10.1093/ajhp/zxag076. Epub ahead of print. PMID: 41810511.