Presentation
Using Eye-Tracking Technology to Study IV Smart Pump Safety and Usability
SessionPoster Session 1
DescriptionIntravenous smart pumps (IVSPs) are critical technologies for the safe delivery of medications in acute and critical care. Despite their widespread adoption, persistent concerns remain related to poor usability, inconsistent flow rate accuracy, and alarm burden. Nurses—the primary end-users—must navigate non-intuitive interfaces, complex programming steps, and frequent nuisance alarms, all of which increase cognitive workload, prolong task time, and elevate the risk of error. These challenges compromise both patient safety and clinical efficiency.
Application of Eye-Tracking in IVSP Research
Eye-tracking technology provides a unique, real-time window into the cognitive processes and attentional demands of nurses as they program and operate IVSPs. By capturing eye movements, fixations, and scan paths, researchers can objectively measure:
• Cognitive workload and error risk: Linking gaze patterns with NASA-TLX workload scores identifies points of confusion and error-prone steps.
• Interface usability: Heatmaps and fixation data reveal where users struggle with complex navigation, hidden menus, or ambiguous labeling.
• Workflow disruption: Eye-tracking during alarm scenarios illustrates how attention is diverted, increasing task switching and risk of oversight.
This method complements traditional usability assessments by providing quantifiable, visual evidence of design-related burdens that nurses experience in real time.
Description of the Study
This was designed to measure and compare the usability of four large-volume IVSPs:
1. Baxter/Sigma linear peristaltic
2. BD/Alaris linear peristaltic
3. ICU Medical DUO (cassette)
4. Ivenix Infusion System (cassette)
Specific Aims
• Aim 1: Measure and compare usability across the four IVSPs using eye-tracking metrics.
• Aim 2: Assess perceived cognitive workload with the NASA-TLX.
• Aim 3: Evaluate programming usability using the Healthcare Systems Usability Scale (HSUS).
• Aim 4: Measure physiologic workload via heart rate variability (HRV) and respiratory rate (RR).
This approach allowed the research team to triangulate objective measures (eye-tracking, HRV/RR) with subjective usability ratings (NASA-TLX, HSUS)
Methods
• Participants: 43 practicing critical care nurses were recruited at the AACN National Teaching Institute (NTI) 2025.
• Design: Observational, non-interventional usability testing in a simulated environment.
• Tasks: Nurses completed 3 common programming tasks (saline infusion, secondary antibiotic, insulin titration) on each pump, with IVSP order randomized to reduce bias.
• Instruments: Tobii Pro 3 Eye-Tracking Glasses, NASA-TLX, HSUS, and Fitbit Inspire 3 (for heart rate variability and respiratory rate).
• Data Collection: Gaze patterns, workload ratings, usability scores, and physiological measures recorded for each device.
Innovation
Although eye-tracking has been used in other healthcare applications, this study represents a novel use of eye-tracking to study the usability of IVSP with experienced critical care nurses. The use of eye-tracking to study IVSPs will provide novel, objective insight into the human-device interaction for nurses delivering life-critical fluid and medications in acute and critical care settings.
Results
Preliminary analysis identifies areas of interest (AOIs) and examines gaze paths and fixation durations while nurses program the IVSPs. Particular attention is paid to differences across the pumps and across the programming tasks. Preliminary results have revealed points of confusion, hesitation, as well as errors in the programming process. It has also highlighted screens, buttons, or alerts that are frequently misread and overlooked. Last, it has led to the identification of “cognitive load bottlenecks” in certain pumps where users must search excessively for information.
Application of Eye-Tracking in IVSP Research
Eye-tracking technology provides a unique, real-time window into the cognitive processes and attentional demands of nurses as they program and operate IVSPs. By capturing eye movements, fixations, and scan paths, researchers can objectively measure:
• Cognitive workload and error risk: Linking gaze patterns with NASA-TLX workload scores identifies points of confusion and error-prone steps.
• Interface usability: Heatmaps and fixation data reveal where users struggle with complex navigation, hidden menus, or ambiguous labeling.
• Workflow disruption: Eye-tracking during alarm scenarios illustrates how attention is diverted, increasing task switching and risk of oversight.
This method complements traditional usability assessments by providing quantifiable, visual evidence of design-related burdens that nurses experience in real time.
Description of the Study
This was designed to measure and compare the usability of four large-volume IVSPs:
1. Baxter/Sigma linear peristaltic
2. BD/Alaris linear peristaltic
3. ICU Medical DUO (cassette)
4. Ivenix Infusion System (cassette)
Specific Aims
• Aim 1: Measure and compare usability across the four IVSPs using eye-tracking metrics.
• Aim 2: Assess perceived cognitive workload with the NASA-TLX.
• Aim 3: Evaluate programming usability using the Healthcare Systems Usability Scale (HSUS).
• Aim 4: Measure physiologic workload via heart rate variability (HRV) and respiratory rate (RR).
This approach allowed the research team to triangulate objective measures (eye-tracking, HRV/RR) with subjective usability ratings (NASA-TLX, HSUS)
Methods
• Participants: 43 practicing critical care nurses were recruited at the AACN National Teaching Institute (NTI) 2025.
• Design: Observational, non-interventional usability testing in a simulated environment.
• Tasks: Nurses completed 3 common programming tasks (saline infusion, secondary antibiotic, insulin titration) on each pump, with IVSP order randomized to reduce bias.
• Instruments: Tobii Pro 3 Eye-Tracking Glasses, NASA-TLX, HSUS, and Fitbit Inspire 3 (for heart rate variability and respiratory rate).
• Data Collection: Gaze patterns, workload ratings, usability scores, and physiological measures recorded for each device.
Innovation
Although eye-tracking has been used in other healthcare applications, this study represents a novel use of eye-tracking to study the usability of IVSP with experienced critical care nurses. The use of eye-tracking to study IVSPs will provide novel, objective insight into the human-device interaction for nurses delivering life-critical fluid and medications in acute and critical care settings.
Results
Preliminary analysis identifies areas of interest (AOIs) and examines gaze paths and fixation durations while nurses program the IVSPs. Particular attention is paid to differences across the pumps and across the programming tasks. Preliminary results have revealed points of confusion, hesitation, as well as errors in the programming process. It has also highlighted screens, buttons, or alerts that are frequently misread and overlooked. Last, it has led to the identification of “cognitive load bottlenecks” in certain pumps where users must search excessively for information.
Event Type
Poster Presentation
TimeMonday, March 234:45pm - 6:15pm EDT
LocationRhinelander Gallery
Medical and Drug Delivery Devices