From no pumps to smart pumps

August 25, 2016

Imagine you’re a nurse and you’re traveling down a bumpy gravel road in the back of an ambulance. Your patient is a newborn baby who desperately needs fluid and the only way to administer that fluid is through an intravenous (IV) line. Now imagine that you had to manually control how that fluid drips and runs through the IV line into the patient, not by way of a mechanical pump, but by eyeballing it and counting the drops per minute.

That was exactly the situation that Heather Keith, Senior Primary Care and Community Health Manager with Peter Ballantyne Cree Nation Health Services, recently confronted. After helping stabilize an acutely ill infant in the far north, Keith traveled with the infant in an ambulance to the nearest airstrip – 130km away – when it became clear the infant needed more help than could be provided locally. The infant was then sent via air medivac to a larger health centre.

“It’s definitely a stressful thing and you really need to be careful,” Keith said. “You’re dealing with very small quantities of fluid such as three drops per minute in a bumpy environment.”

So when she heard that the province was going to be rolling out new smart pumps for intravenous infusions, she was totally onboard. Smart pumps offer a sophisticated technological approach to patient safety. The pumps contain a standardized provincial drug library that identifies safe dosing limits for more than 700 adult and pediatric medications. If the dose is programmed outside the safe limits, it alerts the caregiver, allowing them to check their program and adjust it before a potential error reaches the patient.

“Right away I wondered ‘how can we get those smart pumps?’ and ‘how soon can we get them?’” Keith said.

But there was one small hurdle she knew she would have to overcome first.

As a First Nations organization, her employer – Peter Ballantyne Cree Nation Health Services Incorporated (PBCNHSI) – is funded by the federal, and not provincial, government. The issue facing Keith is that the new smart pumps had been procured on a provincial basis for the Saskatchewan health system. Until recently, this meant that only the regional health authorities and Saskatchewan Cancer Agency were in line to receive the new smart pumps for use in clinical care settings. Not so for other health organizations like PBCNHSI.

So Keith applied for grant money from the Children’s Hospital Foundation for four IV pumps. The grant was approved but when she investigated purchasing the pumps from independent suppliers, she quickly found the price quoted was substantially higher than what was available on the 3sHealth provincial contract and exceeded her grant funding for purchasing the pumps.

When the CEO of the Mamawetan-Churchill River Health Region (MCRHA) brought the situation to the attention of 3sHealth, a collaborative effort was initiated to bring the safety offered by the pumps to PBCNHSI patients. Hospira, as the provincial supplier contracting through 3sHealth, extended the health region pricing for the cost of the pumps and MCRHA allowed the pumps to connect to their regional servers for drug library updates. Regina Qu’Appelle Health Region also stepped up to help, offering to do the biomedical checks required for 3sHealth to download the provincial drug library information for PBCNHSI to receive training in advance of deploying pumps to health centres across their service area.

“This is truly a big leap for us, going from no pumps to state-of the-art smart pumps, and one that we definitely wanted to make for our patients,” said Keith.

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