ALISO VIEJO, Calif. - Oct. 21, 2025 – The everyday use of infusion pumps in patient care often leads to the devices’ complexity and potential risks being underestimated, misunderstood and possibly overlooked.
Formally called intravenous smart pumps (IVSPs), these medical devices are used throughout inpatient and outpatient care settings to deliver fluids, medications and nutrition. Large-volume pumps are the most commonly used, especially in critical care, but IVSPs also include syringe pumps and patient-controlled analgesia pumps.
Approximately 90% of hospitalized patients in the U.S. receive IV medications and fluids, underscoring the importance of IVSP devices to the safe and effective delivery of these therapies. However, complex interfaces, alarm fatigue, programming issues and other usability challenges contribute to medication administration errors that continue to occur at unacceptably high rates.
A symposium in AACN Advanced Critical Care offers a timely and pragmatic examination of key issues on IVSP use in critical care. “When Technology Meets Practice: Infusion Pump Safety in the Real World” includes four articles that highlight the intersection of device design, clinical workflow and patient safety.
Jeannine W. C. Blake, PhD, RN, served as symposium editor. She is an assistant professor, Elaine Marieb College of Nursing and Elaine Marieb Center for Nursing and Engineering Innovation, University of Massachusetts (UMass) Amherst. Faculty members from nursing and engineering, as well as graduate students and long-standing external collaborators, contributed articles to the symposium.
The UMass interdisciplinary Elaine Marieb Center for Nursing and Engineering Innovation integrates the practical insights of frontline nurses with the design expertise of engineers to develop innovative solutions that enhance patient care and healthcare delivery. The center includes an IVSP laboratory that studies how to improve the safety, usability and flow rate accuracy of devices in use, as well as those under development.
“Nurses are often the frontline users of these technologies and serve as the final safety check before medications reach patients. But their expertise is often underutilized when devices are being developed and evaluated,” Blake said. “Closing the gap between innovation and implementation requires ongoing collaboration between clinicians, engineers and manufacturers to develop smarter, safer infusion systems.”
One of the symposium articles, “Beyond Monitors: Intravenous Smart Pump Alarm Fatigue as a Safety Concern,” focuses on how IVSP-related alarm management can be improved to reduce workflow disruptions due to clinically nonmeaningful alerts and decrease cognitive burden for nurses. UMass PhD student Brenda Abena Nyarko, MSN, RN, and Professor Karen K. Giuliano, PhD, MBA, RN, FAAN, co-wrote the article.
“Data support that the majority of IVSP alarms, including high-alert medication infusions, are technical in nature and clinically nonmeaningful for the patient and are resolved without any changes in patient treatment,” Giuliano said. “Unfortunately, IVSP alarms do not distinguish between critical and noncritical events, which further contributes to clinician desensitization and delayed responses. Development of future IVSP technology should include human-centered and data-driven design, as well as close collaboration with device manufacturers.”
Other IVSP-related articles in the journal’s fall 2025 issue include:
- “Optimizing Patient Safety: Intravenous Smart Pump Usability in Acute and Critical Care”
- “Secondary Infusion Underdelivery: Risks and Rewards of Common Workarounds”
- “Critical Care Antineoplastic Infusions: Safety and Practice Essentials”
AACN Advanced Critical Care is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue also includes a topic-based symposium, feature articles and columns of interest to critical care and progressive care clinicians.
Access the issue by visiting the AACN Advanced Critical Care website at http://acc.aacnjournals.org/.
About AACN Advanced Critical Care: AACN Advanced Critical Care is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses and clinical and academic educators. An official publication of the American Association of Critical-Care Nurses (AACN), the journal has a circulation of 1,500 and can be accessed at http://acc.aacnjournals.org/.
About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with about 130,000 members and nearly 200 chapters in the United States.
American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; x.com/aacnme