A national benchmarking survey to explore the use of dose error reduction software in adult intensive care units (ICUs)

Background: Dose Error Reduction Software (DERS) are downloaded onto Smart Pumps with minimum and maximum infusion rate settings to reduce the risk of medication errors when administering intravenous medicines. There are no current national standards for the application of this technology on Adult Intensive Care Units (ICU), and clinical application and governance of this technology is currently unknown. Method: A multicentre, cross-sectional survey was conducted using a self-administered questionnaire to explore practical aspects of Smart Pump containing DERS use, such as whether a DERS library was present, how it was managed, how propofol was administered, what kind of error reporting processes were in place, as well as nursing qualifications and competencies on ICUs in England. Results: A response rate of 50.7% (136/268 responses) ICUs units in England was achieved and indicated that 63.2% (86/136 responses) of responding units had a Smart Pump containing a DERS library. Three administration strategies were used, mg/kg/h, mL/h and ‘Other’ (which most responses stated as mg/h) for propofol for continuous sedation in ICU Smart Pump containing DERS libraries. In 68.6% (49/86 responses) of ICUs, DERS use and DERS error rates are not reported through local operational and governance structures. DERS use was significantly associated with units having a Clinical Nurse Educator with a postgraduate education certificate ( p = 0.005). Conclusions: There are no standardised DERS settings for the anaesthetic agent propofol and inconsistent approaches to Smart Pump containing DERS governance oversight across ICUs in England. Further research is required to understand the clinical significance of identified variability.