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Original research
Comparison of safety and usability between peristaltic and pneumatic large-volume intravenous smart pumps during actual clinical use
  1. Daleen Penoyer1,
  2. Karen Giuliano2,
  3. Aurea Middleton1
  1. 1 Center for Nursing Research, Orlando Health, Orlando, Florida, USA
  2. 2 Elaine Marieb Center for Nursing and Engineering Innovation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
  1. Correspondence to Dr Daleen Penoyer, Center for Nursing Research, Orlando Health Corp, Orlando, Florida, USA; elizabeth.penoyer{at}


Objective To describe and compare safety and usability between a peristaltic large-volume intravenous smart pump (IVSP) and a novel pneumatic large-volume IVSP during clinical use.

Methods A prospective, comparative study was conducted in a large, tertiary hospital in the southeastern USA. Safety and usability were measured by observation during medication administration (medication administration error, interruptions, programming time), dose error reduction system (DERS) compliance, end-user surveys and compliance with manufacturer setup requirements. Study implementation began on a small pilot unit for 1 month, followed by data collection on the study unit over 2 months.

Results For the observed medication administrations (N=158): 79 peristaltic (36 primary; 43 secondary) and 79 pneumatic (42 primary; 37 secondary), use of the peristaltic IVSP was associated with significantly (p<0.05) higher medication administration errors and programming time (11.9 s) and a significantly higher number of interruptions during programming.

DERS compliance was significantly less (p<0.001) with the peristaltic (75.9%) as compared with the pneumatic IVSP (99.8%). Programming workload (National Aeronautics and Space Administration Task Load Index) was significantly (p=0.004) higher with peristaltic versus pneumatic IVSP, and the usability (System Usability Scale) was significantly (p=0.007) lower with peristaltic versus pneumatic IVSP. There was a 0% compliance with peristaltic secondary setup requirements in 43 observed infusions.

Conclusions Though nurses had a high level of experience with the peristaltic IVSP, results of this study support that the pneumatic IVSP was easier to use and associated with fewer errors and deviations from safe practices as compared with the peristaltic IVSP.

  • delivery of health care
  • nursing
  • patient care
  • pharmacology

Data availability statement

All data relevant to the study are included in the article.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

All data relevant to the study are included in the article.

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  • Correction notice This article has been corrected since it was published. Surname of Dr. Giuliano has been corrected.

  • Contributors DP conceptualised the manuscript, wrote the manuscript and supplemental figures and tables and DP coordinated all other author feedback and revisions for the submission. KG led the writing of the background, created the conceptual framework, and contributed significantly to drafting of various aspects of the manuscript, content development and editing. AM contributed the tables for the manuscript and performed contribution to data presentation and editing. DP and KG are guarantor.

  • Funding Funding for the study was provided by an industry research grant from Ivenix, Inc. through their investigator-initiated grant program.

  • Competing interests In addition to the funding statement described above, DP has received industry-funded grants for related studies for investigator-led research from ICU Medical and Ivenix. KG has received study support and has performed consulting services for Ivenix and ICU Medical. AM has received salary support from industry grants from Ivenix and from ICU Medical.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.