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The use of smart pumps can be helpful for preventing medication errors, especially with high-alert drugs in vulnerable critical care patient populations. A literature review was conducted to determine the evidence supporting the use of smart pumps for preventing medication errors. Cinahl and Medline databases from January 2003 through July 2008 were searched for English-language publications on the use of smart pumps and medication errors. Review of these publications revealed that well-designed research is still lacking with respect to the effectiveness of smart pumps in preventing medication errors. Nevertheless, findings indicate new directions for clinical practice and future research.