Pump Hard Limit Safety Settings

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ISMP infusion pump safety Best Practice 8D Nimbus PainPRO post op pain pump Infusion history of ambIT pump after being programmed and delivering 200mL in 1 hour

Competitive electronic pump Infusion History (Hx) display screenshots

Pump Safety Settings

Meeting ISMP's Recommended Best Practices.

Nimbus PainPRO offers the highest level of infusion safety of any single-patient-use post op pain pump. That safety applies to all 12 of its customizable infusion protocols individually and in the aggregate.

What Makes Nimbus PainPRO Safer?
When compared to the market-leading single-patient-use electronic pump:
  • Nimbus PainPRO offers Min/Max hard limits on each infusion mode parameter in each protocol.
  • Nimbus PainPRO offers Global Guard aggregate infusion hard limits.
  • Nimbus PainPRO meets ISMP's smart pump safety Best Practice recommendations.1,2

Institute for Safe Medication Practices: Best Practice 8D
Since 2009, the Institute for Safe Medication Practices (ISMP) has coordinated with ECRI to author guidelines, recommendations, and best practices to drive infusion pump safety and reduce harmful infusion delivery errors. One consistent recommendation made by ISMP is that programmable infusion pumps should utilize dose error-reduction systems (DERS).

ISMP's 2021 Best Practices include recommendation 8D:
If your organization allows for the administration of a… bolus or a loading dose from a continuous medication infusion, use a smart pump that allows programming of the bolus (or loading dose) and continuous infusion rate with separate limits for each.

Nimbus PainPRO's Protocol Library Safety

The Nimbus PainPRO pump offers up to 12 infusion protocol presets. It meets ISMP's Best Practice 8D recommendation via separate hard limits in each of its protocols for each infusion mode: Programmed Intermittent Bolus, Patient Demand Bolus, and Continuous Rate.

The protocol library offers a second layer of safety via its Global Guards. Global Guards act like a "watchdog" working in the background providing aggregate infusion safety hard limits determined by the anesthesia provider, Pharmacy, and any other risk management parties.

Leading Competitor: No Safety Limits

ISMP thinks that programmable infusion pumps with no safety / error-reduction systems increase risk. A leading electronic pain pump competitor to Nimbus has no safety limits. Look at the display screen images to the left. They show this competitive pump's infusion history (Hx) after it was manually programmed to deliver 200mL in just 1 hour.

Lacking any safety parameters, the pump never offered a warning as it was manually programmed to this unsafe rate. And, the pump never offered a warning nor alarm as it was infusing the 200mL in just 1 hour. The pump does not have any protocols built-in. It is manually programmed each time it is used and each time it is titrated.

2020's Top 10 Medication Errors and Hazards

In 2020, ISMP published a list of Top 10 Medication Errors and Hazards noting flawed use of programmable pumps and lower adoption of dose error reduction systems (DERS) among anesthesia providers. ISMP noted that anesthesia providers may not know these capabilities can be applied to bolus doses and loading doses, which are commonly administered in these settings.

ISMP's recommendation for anesthesia providers utilizing programmable pumps: "When possible, they should use upper and lower hard limits and employ the bolus feature with hard limits to avoid catastrophic doses being administered. Bolus doses should not be delivered by simply increasing the infusion rate."3

With its protocol library hard limits and Global Guard hard limits, Nimbus PainPRO meets ISMP's recommendations for avoiding catastrophic doses. And, unlike legacy elastomeric Qball pumps with selectable basal flow rate controllers, you never have to address breakthrough patient pain by simply cranking up the basal rate (and then hoping you remember to turn it down). Nimbus PainPRO offers a Patient Demand Bolus option to more rapidly address breakthrough pain, and it also has the Programmed Intermittent Bolus mode as a more efficient post op analgesia alternative.

1. Institute for Safe Medication Practices (ISMP). ISMP Guidelines for Safe Medication Use in Perioperative and Procedural Settings. ISMP; 2022
2. Institute for Safe Medication Practices. Guidelines for Optimizing Safe Implementation and Use of Smart Infusion Pumps. 2020: Pg. 22. Guideline 4.6.
3. Start the Year Off Right by Preventing These Top 10 Medication Errors and Hazards from 2020. https://www.ismp.org/resources/start-year-right-preventing-these-top-10-medication-errors-and-hazards-2020

Hard Limits for All Infusion Modes