Millions, actually. In the last several years, Hopkins Hospital has invested nearly $15 million in support of nursing safety efforts.

Besides bankrolling the PYXIS technology that aims to improve medication delivery (see “Chasing the Ideal”), hospital leadership also happily opened the coffers when nurses sought safer alternatives to two problems involving traditional IV infusions.

The first was in 2001, when some Children’s Center nurses investigated a long-simmering concern that “drips” posed safety hazards for children. They were right. Medication took longer than they thought to reach the patient, and drips required large volumes of flush fluid to clear lingering medication from the line. “Babies and small children can’t tolerate excessive fluids,” explains Assistant Director of Pediatric Nursing Mary Taylor, who led the study with nursing colleague Allison Murter.

Their findings, along with the potential for human error in preparing IVs, prompted a task force of nurses, physicians and pharmacists to develop a better way. And they found it: The Children’s Center now delivers standardized solutions of almost all continuous infusions and intermittent drugs via customized, automated syringe pumps. They get meds to children faster, with less fluid and numerous safeguards.

Another long-standing IV safety concern, this one on the medical intensive care unit, arose when patients became agitated or were in a lot of pain. Nurses would boost the sedation or pain medication with a bolus and then return patients to their regular drip. But the distracting, multi-tasking nature of nursing left the door open for resetting the IV pump with the wrong rate. “It was an accident waiting to happen,” says Dana Moore, a clinical nurse specialist on the MICU.

Moore and others on the task force took the problem to the patient safety committee, recommending instead a new “smart pump” made by Alaris. These pumps have a drug library that can be programmed with appropriate medications for each setting. They also control total dosage and how many micrograms should drip per minute. “It greatly reduces the chances for making an error because it’s all standardized,” explains Moore. “And it’s more efficient.”

The Alaris Medley pumps rolled out first to urgent care areas, such as intensive care units and operating rooms. By mid-2006, all hospital units will be pumping away.

-From Hopkins Nurse, Fall 2005