The Advantages and Disadvantages of Bar Code Scanning in Medication Administration

The pharmacy, nursing, and informatics department were required to be involved in implementing the bar-code-assisted medication administration (BCMA) patient safety initiative. The involvement of the informatics department was required for planning and coordination of the electronic medication administration record and the scanning devices. The nurses were administering the medications so they were required to undergo training on BCMA methods and the importance of BCMA implementation. Pharmacists were needed to assist nurses in case if a scanning error occurred. Pharmacy, nursing, and informatics staff members were responsible for evaluation of the BCMA system upon implementation.

In the Electronic Medication Administration Record (EMAR) D.B informed me that they would scan the patients’ identification band and then the medication. A medication match is made to deliver the medication safely to the patients. Additionally, there are timeframe lockouts in place, and the high alert medications require a dual sign out. Customarily, like most institutions the Narcotics remaining volume is handoff with the oncoming and off going nurse. Their bedside safety checks are done at the change of shift and office visits flows into the patients’ electronic health record as well as medication review. According to D.B, “Blood sugar and insulin are scanned and the nurses have to attest to the ELearning’s which at times they felt are

Step1: Physician or nurse practitioner order a new medication in Epic. Time spent: 5 minutes

A Research study completed by Bonkowski et al. in 2013 showed that Barcode-Assisted Medication Administration (BCMA) can help to reduce medication administration errors by 40-70% in hospitalized patients. BCMA was implemented at Baylor Scott and White Medical Center- Hillcrest (BSWMC-H) in September of 2014. Since then BCMA scan rates have been well below the expectations for the Emergency Department (ED). In July 2015, BCMA rates for the department were 77% resulting in a medication error rate of 0.74 per 1000 patient days.

While the use of barcode technology has had many applications in hospitals for quite some time it has only recently been used to address patient safety. Mitch Work (2005) views bar code technology as a particularly promising advance in the effort to reduce medical errors. Barcodes provide a valuable verification of medication administration by assuring that the "five rights" are confirmed: right patient, right medication, right dose, right time, and right route of administration. The use of barcode technology at the patient's bedside has shown notable gains in reducing medication administration errors, which may account for as many as 7,000 deaths per year in U.S. hospitals.

“The United States based Institute of Medicine (IOM) reported in 1999 that at least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented…” (Anonymous, 2015). When faced with more than a singular sentinel event related to medication administration errors, the organization must begin to look into why this happened and what can be done to prevent any more errors from occurring. Implementing new bar code technology into a new electronic health record (EHR) system can dramatically reduce the number of errors made by healthcare providers. In order to implement a new system; several steps must occur. An informatics nurse plays a vital role in not only the design of new program interfaces, but in developing educational programs for the new systems. Not all studies have shown that implementing a new bar coding system can be beneficial to healthcare providers, though.

Medication errors are preventable and cause great harm to the patients and their families. Every year in Australian hospitals, medication errors occur as nurses do not follow the 9 rights of medication administration. The 9 rights are right patient, drug, route, time, documentation, response, action and form (Fossum et al., 2016). Medication errors can be caused by

Medication errors are among the most significant cause of patient injury in all types of medical errors (Johnson, Carlson, Tucker, & Willette, n.d). In the nursing profession, medication administration errors occur 34% of the time, second only to physician ordering errors (Gooder, 2011). The introduction of information technology, such as the Bar Code Medication Administration (BCMA), offers new opportunities for reducing medication administration errors. BCMA was developed by the Veteran’s Affairs Medical Center in 1998 to help improve the documentation of medication administration, decrease medication errors and provide

Computerized Vendor Order Entry (CPOE) allows physicians to electronically order the hospital's in-patient medications and treatments and was developed, in part, to avoid errors in prescribing medications (such as drug allergies or drug-drug interactions ). CPOE systems can be programmed to issue a computerized "warning message" alerting physicians to potential problems and conflicts. BIDMC started using a CPOE system about 10 years

. In a nut shell, Medication errors are expensive to any given healthcare center interms of cost, prolonged hospitalization, and death among other risks (Samp, Touchette, Marinac, & Kuo, 2014). If healthcare centers have a good understanding of short term and long term effects of these errors they will be able to justify why BCMA technology is important in redusing the cost, risk, and inefficiency associated with these

My approach to finding research articles were to discover information regarding are there fewer medication errors with the implementation of a barcode medication system, compared to not using the barcode medication administration systems. My focus on finding various studies had to rely on barcode medication, medication error rate, and technology-medication errors. There were many studies out there that focused on medication error rate, which then branched out into IV medication errors, pharmacy errors, nurse’s medication errors, wrong-dose medication errors, and documentation errors, which the list continued. With the barcode medication administration system, will this help reduce medication error rate? The various studies read did a comparison

According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year. An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.

It’s a chilling reality- the number of errors that occur in healthcare. Computerized drug-order entry system has a potential to reduce the number of errors. Physicians and pharmacists have to be involved in reviewing the drugs prescribed. Havening this done it can significantly reduce the harm due to errant medication orders.

Two of the six rights of medication administration are giving the correct medication that was ordered to the correct patient that it was ordered for. Errors occur when the nurse either misreads the order for the medication, or does not check behind themselves. Nurses must learn to take the time to look at the drugs to avoid careless mistakes. Sometimes it may be necessary to have another nurse double check the drugs. To prevent errors in providing correct medication, the nurse should always call the provider if they have a question. A nurse should identify a patient by asking them to state two of the following: their name, date of birth, and/or hospital identification number before administering the medications. To prevent errors nurses should

o solve some of the above-listed issues healthcare systems worldwide have developed easier ways to avoid medication errors and near miss issues such as the electronic medication record (EMAR), CPOE, bar-code medication administration on a portable cart, and automatic medication dispensers. While all these methods of medication administration systems seem to be a safer and easier way to administer medication, it can also be a long process, therefore, resulting in noncompliance behavior that is exhibited by some