Researchers at the University of Massachusetts Amherst are using eye-tracking technology to help understand how nurses interact with intravenous smart pumps, providing a new way to identify design flaws in systems associated with more medication errors than any other route of administration.
The approach, detailed in a study published in the June 2026 issue of Advancing Medical-Surgical Nursing , marks the first known use of eye-tracking technology to evaluate IV smart pumps. By recording exactly where users look while programming the infusion devices, researchers can analyze moments of confusion, hesitation and error that traditional usability studies are not able to capture.
The technology “shows you exactly where the participants are looking and for how long,” explain Karen Giuliano , professor of nursing, and Frank Sup , professor of engineering. Together, they co-direct the Elaine Marieb Center for Nursing and Engineering Innovation (EMCNEI) at UMass Amherst.
The study is part of a broader research program that Giuliano launched in 2012 to examine the safety, usability and clinical performance of IV smart pumps, one of the most widely used tools in hospitals.
Since then, Giuliano and her team have produced more than 30 peer-reviewed publications examining how IV smart pumps perform during clinical use. The team has studied programming errors, IV medication administration practices and errors, alarm fatigue, distractions and other challenges nurses face in real-world conditions.
IV medication administration errors are linked to more serious consequences for patients than any other delivery method. Understanding differences in IV smart pump performance is important, as these devices supply an estimated 1.7 billion infusions across the U.S. healthcare system each year, many of them life-critical.
As part of the newly published study led by EMCNEI doctoral student Seonhun Lee , 31 undergraduate nursing students wore Tobii Pro Glasses 2 eye trackers while programming four infusion pumps. Researchers synchronized visual gaze patterns with pump user interactions to identify where students focused their attention, where they struggled and how errors occurred during programming. The study was conducted in the IV Smart Pump Lab at the Institute for Applied Life Sciences at UMass Amherst.
As summarized by Lee, “Findings from the study, which compared the usability of four different IV smart pumps, revealed significant differences among the different pumps in both programming times for the same IV medication administration tasks and overall ease of use.”
The newest touchscreen-based system generally performed better than older models, which are currently in widespread clinical use, suggesting that interface design plays a significant role in user performance.
The eye-tracking work grew out of a unique collaboration with Shannon Roberts , associate professor of mechanical and industrial engineering at UMass Amherst, whose research has used similar technology to study how drivers interact with vehicle dashboards and safety systems.
“This study provides a great example of how eye-tracking technology can jump from the driving domain straight into a healthcare setting,” Roberts says. “It’s a powerful reminder that our best tools, techniques and metrics rarely stay confined to a single discipline.”
The research team has already completed a national follow-up study using eye-tracking during IV smart pump programming with experienced critical care nurses from hospitals across the U.S. Together, this program of research aims to help manufacturers, healthcare providers and regulators understand how device design shapes clinical performance and patient safety, with the ultimate goal of reducing IV medication administration errors.
The newly published research was supported by a grant from the Sigma Theta Tau Beta Zeta at-Large Chapter and EMCNEI.
Usability, workload, and error rates across four IV smart pumps: A comparative study with novice nurses
1-Jun-2026