Nuisance drug alerts generated by smart infusion pumps can detract from safe care delivery by contributing to alert fatigue and interruptions. This commentary reviews a consensus initiative to decrease insignificant alerts across six health systems. The authors describe how the group standardized smart pump drug library management processes to refine dosage recommendations, policy development, alert review, and data usage to reduce alerts in acute care facilities. A past PSNet perspective discussed the importance of addressing hazards associated with smart pump utilization.