IV Pump or No Pump?
Some JDJ Consulting clients ask, "Why do we sometimes see different pharmacists during our inspections? Why doesn't the same pharmacist come all the time?" I've gone back and forth about how to create the most successful experience for my clients, and ultimately, I've noticed that clients are offered better support when a variety of pharmacists visit their facility. Each member of our pharmacy team brings their own unique experiences and perspectives. This offers our clients the opportunity to learn new things with each visit, with each new pharmacist they meet.
During your pharmacy inspection, JDJ Consulting pharmacists review the contents of the code cart. Some of the medications stocked in the cart, such as dopamine, dobutamine, phenylephrine, lidocaine, nitroglycerin, and norepinephrine, must be diluted and run as an IV infusion on a pump. This leads to the question “Does your facility have a working IV pump?” Many centers have pumps, but the staff may not be familiar with the operation, set up, and proper tubing needed to use it. There are many different types of pumps on the market. Different hospitals and surgical facilities use different types of pumps, so depending on where you were trained, your experience could be very different than your co-worker's. In an urgent situation, each staff member should be able to access and use that pump just as well as the next nurse. Use this as an educational opportunity and run a drill!
Do staff know where the pump is located?
How long does it take staff to locate and retrieve the pump? Time it!
Are staff proficient in setting p the pump and running it?
Are there pre-loaded libraries equipped on the pump? If so, do staff know how to access and run them?
Make sure everyone is comfortable to set the rate or time desired to complete an infusion. Consider using a pump to run a one gram dose of vancomycin over the 90 minute minimum that is required to avoid red man syndrome. It can be used for longer cases where IV fluids are required. A few minutes of training may make things run smoother in the event of an emergency. For centers that do not have an IV pump. It would be prudent to address this on a yearly basis with the medical director and chief of anesthesia as the acuity of patients and case variation may change during the year.