New Process Ensures IV Infusion Pumps Are Readily Available

During the first half of 2015, Cleveland Clinic’s South Pointe Hospital admitted more patients than expected, which presented challenges. “We saw an explosion of our census,” says Lisa Bryant, MHA, BSN, RN, NEA-BC, then Nursing Director for Inpatient Services at South Pointe. “Because many of the patients needed IV fluids or medication, we were concerned about having enough infusion pumps.”

Lisa Bryant, MHA, BSN, RN, NEA-BC

South Pointe had a sufficient number of infusion pumps in house, but nurses couldn’t always obtain them quickly. When caregivers began reporting difficulties locating pumps, Bryant and other leaders jumped into action. They reached out to the healthcare system’s nursing operations team and secured six pumps within two days. But Bryant and others realized that this was only a short-term solution, so they worked on a procedure change to ensure adequate and timely availability of intravenous infusion pumps.

Organizing a ‘no questions asked’ pump collection day

Finding a long-term solution to IV pump availability was imperative. “Nurses focus on delivering safe, effective care,” says Bryant, who now serves as Senior Director of Nursing Education and Professional Development for Cleveland Clinic. “It was very frustrating for them when IV pumps were not readily available.” Nurses and PCNAs occasionally went from floor to floor searching for pumps. While patient care was never at risk, the scramble for pumps was inconvenient and wearisome for nurses. Nurses also went above and beyond to clarify orders with physicians, asking if medications must be given intravenously or if they could be administered orally.

In May 2015, Bryant organized a multidisciplinary workgroup to review the current process for IV pump distribution and identify ways for South Pointe to more efficiently use its resources. One of the workgroup’s first steps was to obtain an accurate count of the hospital’s IV infusion pumps. On June 9, 2015, South Pointe held a hospital-wide Infusion Pump Amnesty Day.

A team with representatives from nursing, central processing, quality, environmental services and facilities went to every patient care area of the hospital and logged information about the total number of IV pumps on the floors, the number being used continuously and intermittently, and the location and storage of those not in use. In addition, the team asked caregivers to place any unused pumps in their soiled utility rooms for collection—no questions asked.

Bryant and her peers then reviewed the results of Infusion Pump Amnesty Day and discovered that only 39 percent of IV pumps at South Pointe were in use. These findings reinforced the workgroup’s commitment to developing a new allocation process.

Changing the IV pump allocation process

Previously, each unit at South Pointe was allocated a certain number of pumps. Nurses and PCNAs were responsible for using and cleaning them. However, this process was inefficient because pump demand varied from day-to-day: Some days a unit would have unutilized pumps, while other days they would not have enough.

Now, pumps are stored at two primary patient points of entry – the Emergency Department and surgery. Several pumps are also kept in the ICU in case of a sudden need. When patients on IV pumps are transferred from the ED or surgery to another unit, the pumps remain with them until no longer needed. Then, nurses place the pumps in the soiled utility room, where they are picked up by the Sterile Processing Department for cleaning. Afterward, the pumps are returned to the ED or surgery.

All staff were educated on the new pump allocation process through the hospital’s Shared Governance committee and during weekly nursing huddles. In addition, Bryant and her team did a lot of one-on-one education on each unit. She admits adoption of the process was not seamless. “We had to remind the nurses that in order for the process to work, the pumps had to be taken to the Sterile Processing Department to be cleaned and put back in the cycle,” says Bryant. “It was challenging for some nurses to give up this piece of equipment that they often had to search for in the past.”

However, the new pump allocation process has caught on and is effective. It’s also had the side benefit of reinforcing unity across the hospital. “It’s helped connect all the departments,” says Bryant. “Staff have begun to look at how we use our resources across South Pointe, not just how we use them in their little corner of the hospital.”