Problems regarding IV pump systems

Home Health Columnist / Guide · May 1, 2014

Moved to Infusion Nursing / Intravenous Nursing for best chance advice.

Asystole RN · May 1, 2014

What setting are you looking at? What kind of patient population? What uses for the pumps? What kind of pumps are you familiar with?

BMT4 · May 2, 2014

It can really be looked at in a most general sense. The idea is that the connection between IV and the patiënt is easily undone as a result of patient movement (and in the case of an IV pole, the movement of the pole).

We are looking at either a hospital setting or patients at home, a setting in which patients are mobile and in use of an IV. I hope this also properly defines the patient population!

Use of pumps is solely to create flow of fluids from IV bags to the patient (flow due to gravity alone not excluded).

Pumps I am familiar with are the Enternal Pump, PCA pump, Insulin pump, syringe pump (not as relevant of course), elastomeric pump, peristaltic pump and more.

Again, the type of pumps are not the main issue, it is the idea that patients connected to pumps or pump-less IV's via catheters experience the problem of catheter disconnection or other problems due to patient/pole mobility, or problems arising as a result from catheter disconnection.

I apologise for maybe not formulating the problem clearly, I am not a native speaker. I hope I stated things more clearly!

BahoRN · May 2, 2014

If not too late, perhaps you might select a topic for your thesis on where a need actually is know to exist and for which information is readily available for.

BahoRN · May 2, 2014

Your selected topic seems quite technical and is very much clinical-oriented. For a BSN topic are you certain your topic shouldn't be more leadership or management focused? Just a thought. Perhaps if you state what your project guidelines are, we could assist you if you'd like.

BMT4 · May 2, 2014

I am quite certain there is an actual need, since the idea for this topic came from a discussion between me and my professor, why heads the Biomedical Technology department of my university, which is directly connected (and resides in) a hospital (UMCG: University Medical Centre).

You're indeed correct that the topic is quite technical. However, the technical part is a concern of mine later into the project. Right now I am very much interested in what experiences people who actually implement the technology (to my knowledge: nurses) have with the IV pumps, this way I can take this into account when designing a new technology.

BahoRN · May 2, 2014

In the hospital, intravenous delivery systems usually become detached from the patient by way of

A) them purposefully pulling it out

B) the patient or healthcare worker accidentally yanking on it and dislodging it, or turning/moving the patient and having the same outcome.

C) getting caught in the line, for example a family member tripping over the tubing

In order to know how prominent this occurrence is, you would need to check the evidence-based literature.

In my experience, I've never seen it dislodged at the pump, or have ever seen the tubing break. I have only seen the catheter pulled out, which means it is still connected to the tubing.

The best way to fix the catheter to the patient would be a brace of some kind, however this is the problem because the big, big worry is pressure ulcers. Therefore a brace can not be a substance that will compromise the skin and tissue beneath. The only way I know of ensuring the catheter does not get pulled out is to wrap the site with gauze and/or netting.

Hope this helps!

KelRN215, BSN, RN · May 3, 2014

I have not found this to be an issue in either hospital care or home care. My patients who are on IVs at home have some sort of central venous access. Their IV pumps may be on poles that they push with them when they get up or they may be inside backpacks that they carry. In pediatrics, peripheral IVs come out a lot because the kids pull them out. I'm not quite understanding what you mean by the connection between the patient and the IV "comes undone" because of the movement of the pole. I have never seen such a thing. The connection from tubing to hub of the IV is tight. As a previous poster said, the entire IV may be pulled out (intentionally by the patient or accidentally by someone else) but I never see the tubing just come disconnected from the IV.

BMT4 · May 4, 2014

Thank you very much for your comments, they are most helpful.

It is indeed about the connection between catheter and patient, not about the lines and IV getting disconnected. Apologies if I was implying that. Posts like BahoRN's are most helpful. I would very much appreciate if people could corroborate this, add situations in which it has happened in their experience, or contradict it through examples.

Have their been any experiences in which the poles on which IV bags are connected have been tipping over due to patients moving about the hospital or home? (I might imagine the poles getting caught on doorsteps).

Any and all posts are helpful, not only those commenting on the problem directly, but also those commenting on my posts, it helps me to know if I am not stating things clear enough. Of course, any problems encountered with IV (pump) systems will be noted, regardless of what part of the system it is about.

BMT4 · May 4, 2014

And if anyone has any literature for available regarding this issue I would of course very much appreciate it!

BMT4 · May 6, 2014

Anyone?