Usability Testing for Smart IV Pumps Through Simulation-based Evaluation

Abstract

Poorly designed user interfaces limit the effective use of medical devices, leading to user errors. Hence, before such devices are implemented, it is essential to identify potential usability issues. A common approach to testing usability is a simulation-based test, which allows practitioners to identify usability issues by observing how users interact with the product being tested. Infusion pumps are frequently used in medical settings, and much effort has been made to advance their design and features. To enhance patient safety, smart intravenous (IV) pumps with safety functions (e.g., drug library, alarms) have been developed. However, they do not always have usable interface designs. A simulation-based test was thus conducted in this study to examine the usability of smart IV pumps. Four smart IV pumps (Pumps 1, 2, 3, and 4) were tested. Table 1 presents their key characteristics. Thirty registered nurses with little experience of using such pumps were recruited from five units at three local public hospitals to participate in the test. They were asked to perform a series of tasks that simulated medication administration involving infusion pumps. A senior registered nurse and human factors professionals developed the following tasks for the test: priming an infusion set; loading an infusion set; accessing the drug library and selecting drugs; and programming a basic infusion. The tasks were performed in a simulated ward to reproduce the nurses’ actual practice. All tasks were performed with each pump, and the order in which the pumps were used was counterbalanced. The nurse participants wore video glasses that recorded their interactions with the pumps during the test. The study’s outcome measures included total task completion time, the number of deviations, the number of alarms, and the number of requests for help. Total task completion time was the amount of time taken to complete all of the tasks. A deviation occurred when the operation of a pump diverged from its standard operation, defined according to the instructions in the relevant pump user manual. Alarms were recorded when aural or visual alerts were caused by deviations and incorrect operation. Requests for help occurred when the participants asked the research assistant how to solve problems they had encountered. Repeated measures analysis of variance was performed to compare the total task completion time between the four pumps. Deviations, alarms, and requests for help were compared by the total number of occurrences