Intravenous patient-controlled analgesia pump and reservoir logistics: Results from a multicenter questionnaire
Purpose: To understand and quantify the logistics (ie, acquisition, utilization, storage, distribution, maintenance, repair) of intravenous patient-controlled analgesia (IV PCA) pumps and analgesics in the acute postoperative pain setting.
Methods: As part of a larger multicentered, observational study, 29 hospitals in the United States were surveyed to examine IV PCA logistics. Data were collected via interviews with hospital staff using a standardized hospital questionnaire. Descriptive statistics were calculated on all site characteristics and IV PCA logistics data.
Results: Average beds per hospital and inpatient surgery volume per year were 455.5 beds and 6,483.2 patients. The majority of sites (75.9%) owned their pumps and, on average, reported 1.3 pump types and 2.3 different storage locations. Most hospitals utilized 3 of 4 different opioid agents (ie, morphine, fentanyl, hydromorphone, meperidine). Morphine is the most common prefilled reservoir (75.9%), while hydromorphone is the most common pharmacy staff-filled reservoir used (72.4%). A fentanyl staff-filled reservoir is available in 62.5% of the hospitals.
Conclusions: The process of providing IV PCA from initial order to setup is complex and variable. The process to IV PCA initiation involves the understanding of various types of pumps and analgesics, coordination of hospital staff, and substantial time to implement. Future postoperative care should explore improved technologies (or means of delivery) to reduce the complexity and steps involved with IV PCA while continuing to deliver on-demand pain relief.