Template

IV Smart Pump Library Review & Safety Audit Template

An interactive audit template to review smart-pump libraries, version control, high-risk medication parameters, alert behavior, and interdisciplinary review cadence. Collects structured findings, risk ratings, and recommended actions to support continuous improvement and safer IV medication delivery.

Interactive Tool

IV Smart Pump Library Review & Safety Audit

This interactive template helps interdisciplinary teams (pharmacy, nursing, and biomedical engineering) run structured reviews of smart-pump libraries to detect unsafe entries, library drift, and alert issues. Use this form during regular library reviews and after significant medication or workflow changes. Suggested cadence: monthly for high-risk areas, quarterly for general libraries, and after any serious medication event. Record findings, assign actions, and save each audit so the organization builds an auditable improvement history.

Who should participate

Pharmacist lead, nursing pump super-user, biomedical engineering or clinical engineering representative, and a safety/quality representative when available.

Why this matters

Consistent libraries, clear hard/soft limits, and well-managed alerts reduce programming errors, prevent harm, and decrease alarm fatigue.

Local tracking ID or leave blank to auto-generate
YYYY-MM-DD
Where this library is used (e.g., ICU, ED, OR, Home Infusion)
e.g., 'MainHosp_IVLib_v1.2' or repository link
Summarize recent changes since previous review
Name and role (e.g., 'Jane Doe, Pharmacy Manager')
List other high-risk items reviewed
For each medication or profile reviewed, confirm the following parameters. Provide per-med notes below.
Soft limits should be clinically appropriate and reviewed with pharmacy
Hard limits should prevent dangerous dosing errors
Check mg vs mcg, mL vs L, and concentration expressions
Prevent inadvertent large boluses or infusions
Include default weight units and any rounding rules
Name medication, current parameters, issue found, and recommended correction (one per line)
If sampling device logs, enter count for review period
List common alerts (e.g., 'Dose limit override', 'Occlusion false positives') and approximate frequency
1 = very low, 5 = very high
1.0 10.0
Examples: adjust sensitivity, change alarm text, update escalation pathway
Note duplicate entries, inconsistent naming, or orphan profiles
Describe test scenarios used to verify library behavior (e.g., simulated insulin bolus, titration scenario) and results
List findings that must be corrected before next shift or patient exposure
1 = Low risk, 5 = Critical risk
1.0 10.0
Be specific: 'Pharmacy will update insulin profiles to correct unit conversions by 2026-09-15; BE will deploy to pumps by 2026-09-20'
Names and roles, separated by commas
YYYY-MM-DD
Capture disagreements, unresolved items, or items for escalation
Paste links to change logs, screenshots, vendor release notes, or uploaded file references
Enter names of participants who reviewed and approved this audit entry
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