Researchers in the US are using eye-tracking technology to help understand how nurses interact with intravenous (IV) smart pumps.
It will provide a new way to identify design flaws in systems associated with more medication errors than any other route of administration, they said.
“Findings from the study, which compared the usability of four different IV smart pumps, revealed significant differences”
Seonhun Lee
The researchers, from the University of Massachusetts Amherst, said their study would provide new evidence that the design of devices played a critical role in preventing clinical errors.
They said their approach, published in the journal Advancing Medical-Surgical Nursing, marked the first known use of eye-tracking technology to evaluate IV smart pumps.
By recording exactly where users look while programming the infusion devices, the researchers can analyse moments of confusion, hesitation and error that traditional usability studies cannot capture.
The technology “shows you exactly where the participants are looking and for how long”, said study authors Karen Giuliano, professor of nursing, and Frank Sup, professor of engineering.
Together, the pair of professors co-direct the university’s Elaine Marieb Center for Nursing and Engineering Innovation (EMCNEI).
The study is part of a broader research programme that Professor Giuliano launched in 2012 to examine the safety, usability and clinical performance of IV smart pumps.
Since then, she and her team have produced more than 30 peer-reviewed publications examining how IV smart pumps perform during clinical use.
The team has studied programming errors, IV medication administration practices and errors, alarm fatigue, distractions and other challenges nurses face in real-world conditions.
As part of the new study, which was led by EMCNEI doctoral student Seonhun Lee, 31 undergraduate nursing students wore Tobii Pro Glasses 2 eye trackers while programming four infusion pumps.
Researchers synchronised visual gaze patterns with pump user interactions to identify where students focused their attention, where they struggled and how errors occurred during programming.
The study, which compared the usability of four different IV smart pumps, revealed significant differences among the devices in both programming times for the same IV medication administration tasks and overall ease of use.
The newest touchscreen-based system generally performed better than older models, which are currently in widespread clinical use, suggesting that interface design plays a significant role in user performance.
Writing in the journal, the study authors said: “Although IV smart pumps perform the same clinical functions, they vary substantially in usability, programming accuracy and perceived cognitive workload.
“These findings underscore the importance of designing devices to be aligned with their intended use, environments in which they will be used, and clinical user needs.”
Shannon Roberts, associate professor of mechanical and industrial engineering at the university, has used similar technology to study how drivers interact with vehicle dashboards and safety systems.
She said: “This study provides a great example of how eye-tracking technology can jump from the driving domain straight into a healthcare setting.
“It’s a powerful reminder that our best tools, techniques and metrics rarely stay confined to a single discipline,” she added.
The research team has already completed a national follow-up study using eye-tracking during IV smart pump programming with experienced critical care nurses from hospitals across the US.
Together, it aims to help manufacturers, providers and regulators understand how device design shapes clinical performance and patient safety, with the goal of reducing IV administration errors.
The newly published research was supported by a grant from a chapter of the nursing organisation Sigma Theta Tau.
