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Smart pumps, incorporating dose error reduction software, are widely promoted as a patient safety intervention.1 ,2 This software checks programmed intravenous infusion rates against preset limits for each drug in the pump's ‘drug library’ with the aim of reducing the risk of infusion rates that are too high or too low. Smart pumps were reported to be in use in 68% of US hospitals in 2011,3 although this figure does not tell about how they are used nor in which clinical areas. A UK study indicated less widespread use and that although smart pumps may be in use within an organisation, they may only be used in some clinical areas or for certain kinds of infusion.4
Although widely advocated, as with many other patient safety interventions,5–7 the evidence for smart pumps' benefit is not clear-cut. No conclusive evidence shows that smart pumps do indeed prevent medication errors and adverse drug events, and we know little about the kinds of errors that still occur with their use.8 ,9
In this issue, Schnock et al10 aim to shed light on some of these issues by documenting the prevalence and types of errors associated with intravenous infusions in 10 US hospitals using smart pumps. Pairs of observers visited participating clinical areas and identified discrepancies between each infusion and its corresponding medication order plus relevant organisational policies. This method can reveal only errors visually apparent from an infusion in progress. Any …