“Everyone has infusion pumps,” is a phrase we hear a lot when talking to nurses in the United States. Certainly, the prevalence of infusion pumps in modern U.S. healthcare settings would seem to support this. When we first set out to develop the DripAssist we thought this too, and aimed at supporting and advancing healthcare environments overseas where resources were more limited. At Shift Labs we get a kick out of people proving our preconceived assumptions false and we were thrilled, and surprised, when care practitioners starting coming to us asking for the DripAssist. As it turns out, there are numerous settings in the U.S. healthcare system where gravity infusion is still utilized. We decided it would be worth reviewing some of these in a blog series.
Gravity Infusion in the Modern Practice
Part 1: Rheumatology Infusion Centers
Nearly 1.5 million people in the United States suffer from rheumatoid arthritis (RA). RA is an autoimmune disease that creates pain and inflammation by causing the body’s immune system to attack its own joints. If left untreated, this disease can cause permanent systemic damage. In order to slow progression of the disease, rheumatology nurses will often utilize biologic therapies, or biologics. Biologics are specially engineered proteins which inhibit parts of the immune system that cause inflammation. Biologics are often administered in outpatient rheumatology clinics by way of short IV infusions, usually fifteen minutes to an hour in length.
Many rheumatology clinics are fairly small organizations, and because so many people suffer from RA, they tend to treat a large number of patients in small periods of time. In order to meet the demand, some clinics will administer biologics using gravity infusion instead of infusion pumps. A single infusion pump can cost thousands of dollars to purchase, and upkeep of these devices is also costly. Gravity infusion is a much less expensive alternative to infusion pumps allowing rheumatology clinics to treat more people using smaller budgets.
One downside to using gravity infusion over a pump, is that gravity infusion requires nurses to hand-count drops with a clock each time they set or check the infusion. Where an infusion pump will digitally set and show the infusion flow rate, gravity infusion involves the arduous and error-prone task of counting drops to determine flow rate. Research for Shift Labs’ latest white paper revealed that up to 75% of gravity infusions are set at rates either higher or lower than prescribed.
We recently spoke with a rheumatology nurse who told us that flow rate errors are of particular concern with RA infusion treatments. Clinics are often overloaded with patients, she said, and nurses need to administer treatments within certain timeframes to be able to treat all of their patients for that day. Additionally, certain medications must be administered in very specific ways. For example, some biologics are administered over the course of an hour with the flow rate increasing at certain intervals during the treatment. A flow rate that is too high or too low, she explained, will not only affect the nurse’s schedule but it will also impact the efficacy of the treatment.
When it comes to RA treatment, infusion flow rate accuracy is of the utmost importance. Flow rate accuracy saves provider time and ensures treatments are as therapeutic as possible. Unfortunately, gravity infusion is inherently inaccurate. Fortunately, these inaccuracies can be prevented. To learn more check out Shift Labs’ newest white paper “More Accuracy in Less Time."