Nurses’ Perceived Ease of Use,Mental Effort,and Likelihood of Programming Errors for Four Infusion Pumps

Abstract

In this study, we report on nurses’ perceptions of the ease of use of four infusion pumps, the mental effort exerted when using the pumps, and the likelihood of programming errors. The key features and operations of the pumps are presented in Table 1. Perceptions were measured after each pump was used in an end-user test. This involved performance of simulated infusion tasks developed by a group of healthcare professionals including nurses and physicians, based on the practical tasks nurses perform with infusion pumps. The tasks included priming and loading the infusion sets, the startup and shut down of the infusion pump, setting basic infusion, and the use of a drug library. The test was conducted in a simulated patient room with a bed, drip stands, and a trolley loaded with solution bottles and administration sets. Sixty registered nurses from five clinical units of three large public hospitals were studied. Perceived ease of use was assessed by seven items adapted from Ginsberg (2005), of which two items (I1 and I2) concerning sets priming and loading (e.g., “Easy to prime and load”), three items (I3, I4, and I5) concerning basic infusion setting (e.g., “Easy to program a basic infusion”), one item (I6) concerning turning on/off the pump (i.e., “Easy to turn on and turn off the pump”), and one item (I7) concerning the usage of drug library (i.e., “Easy to program a drug infusion from drug library”). The items were rated on a 7-point scale ranging from 1 (very strongly disagree) to 7 (very strongly agree). Perceived mental effort was measured by two items (I8 and I9; e.g., “How much mental effort is required when setting up and programming the infusion pump?”), and perceived likelihood of programming errors was examined by one item (I10; i.e., “How likely is it that you would make infusion pump programming errors due to the complex design of the pump?”). These were rated on a 7-point scale ranging from 0 (not at all) to 6 (a great deal). Using a one-way repeated measures analysis of variance, we compared the differences in each of the three perception variables among the four pumps. The correlations among the variables were evaluated using Pearson correlation coefficients. Table 2 shows the means and standard deviations of the variables and the pairwise comparison results. Our results indicated that Pump 3 yielded the highest perceived ease of use, followed by Pump 2, Pump 4, and Pump 1. Pump 3 also achieved a lower perceived mental effort and a lower likelihood of programming errors than the other pumps. Perceived ease of use was negatively correlated with perceived mental effort (r_pump1 = -0.53, r_pump2 = -0.39, r_pump3 = -0.54, r_pump4 = -0.30, all p values < 0.05) and perceived likelihood of programming errors (r_pump1 = -0.54, r_pump2 = -0.34, r_pump3 = -0.60, r_pump4 = -0.49, all p values < 0.01). It appears that an infusion pump that provides informative feedback on its status and allows simple programming operations is more likely to be perceived as easy to use. Improving the ease of use of the pumps may reduce the mental effort required, and users may perceive they are less likely to make programming errors during use. Critical to the design of effective infusion pumps is the consideration of human factors, which can improve ease of use and simplify the design.