• Isabel Muñoz Ojeda, Marina Sánchez-Cuervo, Ángel Candela-Toha, Dolores R Serrano-López, Teresa Bermejo-Vicedo, and Juan Miguel Alcaide-López-de-Lerma.
• Isabel Muñoz Ojeda is a pharmacist, Pharmacy Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
• Crit Care Nurse. 2023 Aug 1; 43 (4): 303830-38.

BackgroundThe risk of medication errors in intensive care units is high, primarily in the drug administration phase.Local ProblemManagement of high-alert medications within intensive care units in the study institution varied widely. The aim of this quality improvement project was to protocolize and centralize the management of high-alert medications in acute care settings and to implement smart intravenous infusion pump technology in intensive care units.MethodsThe project was conducted in 4 phases: (1) protocolization and standardization of intravenous mixtures, (2) centralization of intravenous mixture preparation in the Pharmacy Department, (3) programming of the smart pumps, and (4) dissemination and staged implementation of intravenous mixture protocols. Smart pumps (Alaris, CareFusion) were used to deliver the medicines, and the manufacturer's software (Alaris Guardrails, CareFusion) was used to analyze data regarding adherence to the drug library and the number of programming errors detected.ResultsMorphine, remifentanil, fentanyl, midazolam, dexmedetomidine, and propofol were included. After implementation of the smart pumps, 3283 infusions were started; of these, 2198 were programmed through the drug library, indicating 67% compliance with the safety software. The pumps intercepted 398 infusion-related programming errors that led to cancellation or reprogramming of drug infusions.ConclusionsProtocolization and centralization of the preparation of high-alert sedative and analgesic medications for critically ill patients and the administration of these drugs using smart pump technology decrease variability of clinical practice and intercept potentially serious medication errors.©2023 American Association of Critical-Care Nurses.

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