Date of Award
2026
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Karen Frith
Subject(s)
Medical informatics, Medication errors--Prevention, Nursing errors--Prevention, Drug infusion pumps
Abstract
Alert fatigue is a significant issue in healthcare leading to desensitization and increased risk of adverse drug events (ADEs). The aim of this project was to reduce the number of alerts and overrides to decrease infusion-related near-miss ADEs by optimizing Dose Error Reduction Software (DERS) on smart infusion pumps. A comprehensive review of current evidence indicated that high override rates are a symptom of alert fatigue. Significant variations in alert fatigue across institutions demonstrate that institutional practices and misalignment of DERS are the root causes of alert fatigue. This Doctor of Nursing Practice (DNP) project was led by a nurse informaticist in collaboration with a multidisciplinary team, utilizing a systematic approach to optimize the DERS. The intervention involved a review of alerts, overrides, and near-miss ADEs before and after optimization of the DERS, four improvement cycles to identify high override medications, and alignment of DERS settings with best practices for the identified medications. This project revealed that optimizing DERS utilizing a multidisciplinary team at a hospital reduced mean total alerts (4.87 to 2.57, p < 0.001), mean total overrides (3.35 to 1.94, p < 0.001) related to smart infusion devices, and the number of near-miss ADEs (from five to two, p < 0.29). These results demonstrate the value of regular review of infusion medications delivered through intravenous (IV) smart pumps and optimization of DERS to reduce alert fatigue and improve patient safety.
Recommended Citation
Johnston, Sarah, "Optimizing IV smart pump software to reduce alerts, overrides, and adverse drug events" (2026). Doctor of Nursing Practice (DNP). 156.
https://louis.uah.edu/uah-dnp/156