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What This Guide Helps With
Addresses suspected inaccurate feeding caused by setup, disposable sets, tubing, test technique, positioning, configuration, or pump performance problems.
Step-by-Step Troubleshooting
1. Remove the Pump From Patient Use
If feed delivery is suspected to be inaccurate, discontinue use of that pump for patient feeding until accuracy is verified.
Provide another verified pump or approved alternate feeding method.
Expected outcome: The patient is not exposed to potentially inaccurate delivery.
2. Confirm the Complaint
Determine whether staff observed too much volume, too little volume, unexpected bag depletion, a discrepancy between programmed and delivered volume, or a failed Clinical Engineering performance test.
Record the programmed rate, dose, and relevant setup information if available.
Expected outcome: The accuracy concern is precisely defined.
3. Verify Programming and Configuration
Confirm that the test or reported feeding was programmed as intended, including rate, dose, feed/flush mode, and any other relevant settings.
Do not alter clinical configuration merely to make a test pass.
Expected outcome: The discrepancy is not caused by incorrect programming.
4. Inspect the Disposable and Tubing
Check for incorrect set type, stretched or flattened tubing, partial occlusions, air, damaged connectors, leaks, or improper cassette loading.
Expected outcome: The fluid pathway and disposable are suitable for an accuracy test.
5. Verify Test Setup
Use the approved Clinical Engineering test method and suitable measuring equipment.
Ensure that container placement, tubing routing, test duration, measurement method, and any environmental factors conform to the applicable procedure.
Expected outcome: The test setup itself does not introduce a measurement error.
6. Repeat With a Known-Good Set
Install a new or known-good compatible feeding set and repeat the accuracy evaluation.
Disposable tubing characteristics can affect pumping performance.
Expected outcome: Accuracy meets the applicable manufacturer or facility tolerance with a known-good set.
If it passes, remove the questionable disposable from use and document the result.
7. Check for Fluid Leaks or Losses
Inspect all external connections and the test container for leakage, dripping, splashing, or retained fluid that could make delivered volume appear incorrect.
Expected outcome: All pumped fluid is captured and measured accurately.
8. Repeat the Approved Accuracy Test
Repeat the performance test using the applicable manufacturer procedure and approved test equipment.
Do not average away an unexplained failed result.
Expected outcome: Delivered volume falls within the applicable tolerance.
If the pump repeatedly passes, document the condition and stop troubleshooting.
9. Confirm Repeatability of Any Failure
If the pump fails, repeat only as permitted by the approved service procedure to confirm the result is repeatable rather than caused by test setup.
Expected outcome: A true pump-specific accuracy failure is differentiated from a setup error.
10. Escalate an Out-of-Tolerance Pump
If delivery remains outside the applicable tolerance with a verified setup and known-good disposable, remove the pump from service.
Expected outcome: An inaccurate feeding pump cannot return to clinical use without corrective service.
If the Problem Persists
Programming, disposable sets, tubing, fluid loss, positioning, and test technique have been ruled out. Remaining causes may involve the pumping mechanism, drive components, calibration, sensing, or another service-level performance issue.
The pump should be removed from service, labeled Out of Service, and evaluated using appropriate Cardinal Health service documentation and calibrated test equipment. Calibration or repair should be performed only by qualified personnel. A complete applicable performance verification is required before return to service.
Knowing when an accuracy failure requires escalation is proper troubleshooting.
Clinical Use Tip
Never return a feeding pump to service based only on normal appearance or operation if it has failed a valid delivery-accuracy test.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that the Kangaroo Joey appeared to deliver less formula than the programmed volume."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the installed feeding set tubing was deformed and the pump passed the approved accuracy test with a known-good set."
Resolution
What action was taken.
Example:
"Removed the affected disposable set, verified delivered-volume accuracy with the approved test setup, and returned the pump to service."
Helpful Details to Include (If Known)
- Programmed rate and dose
- Reported delivered-volume discrepancy
- Disposable set type and condition
- Tubing routing
- Test equipment used
- Test method followed
- Known-good set result
- Measured result
- Repeatability of failure
- Corrective action
- Final device status
Final Thought
Accuracy troubleshooting depends on controlling the test setup, eliminating disposable and programming errors first, and escalating any repeatable out-of-tolerance result rather than assuming normal operation.
That is successful troubleshooting.