Table 2.
Identified Prevention Strategy Types and Subtypes
| Prevention Strategy | Subtype | Example References |
|---|---|---|
| Training (P1.0) | Training refreshers (P1.1) | A51, A64, A82 |
| Train on how and why (P1.2) | A5, A64, A88 | |
| Nurse Involvement in Design and Evaluation (P2.0) | Resource super users (P2.1) | A5, A64 |
| Nurse input for design (P2.2) | A64, A81 | |
| Uniform Pump Brand/Function (P3.0) | Standardize pump fleet (P3.1) | A43, A94 |
| Consistency Between Systems (P3.2) | A64 | |
| Improve Communication & Reliability (P4.0) | Redundant, independent medication checks by 2 people (P4.1) | A45, A49 |
| Medication review on transfer (P4.2) | A43 | |
| Automation/Logic (P5.0) | Automate medication titration (P5.1) | A69 |
| Logic for titrated drugs (P5.2) | A8 | |
| Integrate pumps with lab or vital sign data (P5.3) | A69 | |
| Automated error alert systems (P5.4) | A24, A92 | |
| Technological Integration of Systems (P6.0) | Barcode Scanner (BCMA) integrated with EHR (P6.1) | A73, A95 |
| Infusion Pumps Interfaced with EHR and BCMA (P6.2) | A90, A92, A95 | |
| Standardize and Update Drug Libraries (P7.0) | Limit and standardize medication concentrations (P7.1) | A77, A86, A87 |
| Include bolus doses in library (P7.2) | A8 | |
| Scheduled library updates (P7.3) | A62, A71 | |
| Increase Compliance (P8.0) | Compliance with library, default to DERS, monitor compliance (P8.1) | A35, A65, A84 |
| Compliance with pump protocol (P8.2) | A83 | |
| Simplify programming process to improve compliance (P8.3) | A3 | |
| Decrease unnecessary warnings (P8.4) | A8 | |
| Minimize workarounds (P8.5) | A8, A88, A96 | |
| Interpump constraints – checking of infusion parameters between and across pumps (P8.6) | A49 | |
| Hard limits on new smart pumps (P8.7) | A43 | |
| Organizational Factors (P9.0) | Eliminate Resource Constraints (P9.1) | A64 |
| No ‘One Size Fits All’ Policies (P9.2)– policies are specific and tailored to the needs of the patient population and clinical context | A64 | |
| Policies and procedures to standardize processes and best practice (P9.3) | A9, A19, A105 | |
| Limitation of Interruptions (P9.4) | A10, A74 | |
| Human Factors/Quality Improvement (P10.0) | Continuous QI with scheduled data review to improve pump use and compliance with DERS (P10.1) | A6, A11, A53, A71 |
| Use of Failure Mode & Effects Analyses (FMEA) (P10.2) | A17, A31, A73, A98 | |
| Standardized medication concentrations (P10.3) | A77, A86, A87 | |
| Human factors informed labels, e.g., redesigning med labels to have higher readability, formatting consistent with pump programming info needs, color-coding, etc. (P10.4) |
A87, A94 | |
| Checklists (P10.5) | A49 |
Numbers in column 3 refer to the IDs for each article in the Appendix. Abbreviations: BCMA, barcode scanner; EHR, electronic health record; QI, quality improvement; FMEA, failure mode & effects analyses