How eye tracking is improving medical device safety

Dr. Karen K. Giuliano is a critical care nurse, a practicing nurse scientist at Baystate Medical Center, and Co-Director of the Elaine Marieb Center for Nursing and Engineering Innovation at the University of Massachusetts Amherst.  Karen leads an interdisciplinary research team that includes collaborators from both within and outside of UMass who are conducting groundbreaking research on the clinical use and performance of IV smart pumps.  This innovative program of research combines her clinical experience with cutting-edge research tools like wearable eye tracking to generate novel data for improving the safety and usability of IV smart pumps. 

Usability issues with life-saving devices  

Every day in hospitals, nurses rely on essential medical devices like IV smart pumps to support the delivery of safe, effective patient care. But what happens when these devices are overly complex, poorly designed, or just plain inefficient?

For Dr. Karen K. Giuliano the answer was clear: design matters — and nurses need to be at the center of the conversation. While working in industry on IV smart pump development, Karen quickly recognized that these widely used devices, which are found in nearly every hospital room and are used to administer life-critical fluids and medications, too often present increased usability and safety challenges. When nurses must expend significant mental, physical, and emotional effort to navigate and troubleshoot these devices, it compromises both patient safety and the well-being of the nursing workforce.

Her next step was to look to the research literature for guidance. What she found surprised her: there were no nurses leading research in this critically important area. So, she decided to change that.  

Bringing eye tracking into clinical research

Karen turned to Tobii eye tracking to study how nurses interact with medical devices in real-time. At the heart of Karen’s recent research was a usability study of four different IV smart pumps. To evaluate how well nurses could interact with each pump, participants were brought into a realistic simulation lab and asked to complete a series of clinically relevant tasks. 

“We literally brought our UMass team and set up our IV smart pump lab at a hotel in New Orleans and completed a complex usability study with a national sample of critical care nurses in 4 days.  It was an incredibly successful and rewarding experience, and the UMass and Tobii teams were absolutely fantastic.”

This wasn’t just a matter of measuring how fast nurses could push buttons. The study used Tobii wearable eye tracking glasses to record exactly where nurses were looking while using each device. This allowed researchers to pinpoint which features drew attention, which were missed, and which interfaces caused hesitation, confusion, or error. 

In addition to eye tracking, nurses completed surveys after each task to provide subjective feedback on the ease or difficulty of use of each device, helping Karen and her team compare the pumps not just on performance, but on perceived usability. 

"The eye tracking data proved invaluable. As nurses completed tasks, the Tobii software created visual maps of their gaze patterns — highlighting the exact areas on the pump interface where they focused, hesitated, or got stuck."

This made it possible to identify high-risk design flaws like: 

• Visual clutter that delayed task completion 

• Poor label placement that confused users 

• Inconsistent navigation between menu options 

By combining objective eye movement data with subjective survey feedback, Karen’s team was able to paint a rich picture of which pump designs supported nurse workflow and which posed the highest risks for error. 

Why it matters

Every second counts in critical care. If a nurse needs to stop and figure out how to navigate a pump’s confusing user interface, it’s not just inconvenient—it can and does result in IV medication administration errors that can endanger a patient's life.

This research offers more than just critique. It offers evidence-based insights into how device design can better support nurses, reduce cognitive load, and ultimately improve patient safety. By decreasing the mental workload of every nurse, the hope is that they can also increase nurse retention and reduce stress. 

This partnership between nursing, engineering, and technology is a model for how interdisciplinary collaboration can drive meaningful change in healthcare. By using tools like eye tracking to better understand the human-technology interface, researchers like Giuliano are making care safer for patients and better for nurses. 

The Tobii Insight professional services team provided hands-on support throughout the project, from setup to data analysis. “We are partners in research,” they shared. “Our goal is to assist and benefit other researchers in their eye tracking journey, at any stage of the process.” 

Are you considering using eye tracking in your next research project?

Tobii offers support services tailored to academic or commercial projects. Whether you’re just starting out or deep into data analysis, our team is ready to help make your research a success. Connect with our team.