H.4 Silent Night IV pump

Hospital Acquired Delirium is a major contributor to morbidity and mortality in the inpatient setting. This condition is characterized by waxing and waning mental status that can occur in elderly folks after even only a few hours in the healthcare setting and persist for many months after hospitalization. The prevalence is up to 64% in some studies and is associated with a 33% mortality rate in the hospital setting.1,2 One contributor to Hospital Acquired Delirium is the countless machines that “beep” ceaselessly, at different intervals, and different pitches throughout the day and night. One such “beep” comes needlessly from IV pumps – the machines that feed medications and fluids into patients’ IVs. These machines will beep for a number of reasons including clogs, completion of the medication, and prolonged pauses. Each one of these beeps must be heard by the nurse and then acted on in person – increasing the frequency of patient disruption and further worsening the risk for delirium. 

At the moment, the methods we have to reduce Hospital Acquired Delirium are limited. They focus largely on minimizing disruptions to the patients’ circadian rhythm and re-orienting them to their surroundings. We open windows when the sun is up and close them at night. We open doors to the hospital room during the day to increase human interaction. We reduce blood draws at night to allow the patient to sleep. These measures have been shown to be effective, but ultimately insufficient. 

One simple solution to reduce the burden of Hospital Acquired Delirium is to eliminate some of the “beeps” And disruptions. Certainly in this day-and-age, we can create IV pumps that communicate silently with the nursing staff and be acted on from afar . This new age of IV pump would communicate with a central hub (presumably at the nursing station) that nurses would be able to interact with without the patient ever hearing or seeing anything at all. Nurses would be able to change drip rates, un-pause drips, and attempt simple fixes to the machines without even having to enter the patient room. If successful, this new IV pump/central monitoring system has the potential to be the standard of care in all inpatient hospital units.

1. Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. Lancet.(2014) 383:911–22. 10.1016/S0140-6736(13)60688-1 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

2. Leslie DL, Marcantonio ER, Zhang Y, Leo-Summers L, Inouye SK. One-year health care costs associated with delirium in the elderly population. Arch Intern Med. (2008) 168:27–32. 10.1001/archinternmed.2007.4 [PMC free article] [PubMed] [CrossRef] [Google Scholar]