Dose Error Reduction Systems: Features and Functions

Dose error reduction systems (DERS) allow infusion pumps to warn users of incorrect medication orders, calculation errors, or misprogramming that would result in significant under- or overdelivery of a drug, electrolyte, or other fluid. Infusion pumps that have a DERS are often referred to as "smart" pumps. DERS are an important part of a facility's defenses against medication errors and are available on large-volume (also known as general-purpose), syringe, and patient-controlled analgesic (PCA) pumps. (It should be noted that although ambulatory pumps can incorporate onboard limits, they don't offer the full features of a DERS and don't fit within the smart-pump category.) Most infusion pumps sold in the United States, and some models marketed in other countries, now have a DERS or onboard protocol library.

ECRI Institute does not recommend using an infusion pump without a DERS for general patient care. However, we recognize that many hospitals use very basic pumps that do not have a DERS for some specific applications in which the precise rate is not important (e.g., administration of antibiotics, fluid maintenance); this practice is safe as long as the hospital takes precautions to ensure that more potent medications are not administered with these devices.

DERS technology has advanced since the early systems that consisted of a simple drug library that had to be manually loaded onto each pump. Since the introduction of DERS in large-volume pumps,...