Assisted Medication Administration : A Method For Predicting Repackaging Resource Needs

It’s not simply the particular giving of the medications that fare up all the time. It is checking the medical record with the hand written prescriptions, grouping the varied medications and also the instrumentation for giving them, and ensuring all the patients safety measure are covered.

Improved patient safety is the most essential advantage of the BCMA system. “On average a hospital patient is subjected to at least one medication error per day (IOM, 2006)”(Foote). BCMA significantly reduces medication errors that cause a compromise in patient safety. The BCMA verifies the five rights of medication administration before a patient receives a medication by the software alerting the nurse if there is a contraindication between the medicine scanned and the patient’s orders. A pilot study conducted at a 300-bed community hospital found that the BCMA system reduced medication errors by 80% (Foote). Fowler et al states that “decrease in errors related to the wrong patient was a direct result of the bar code system (Fowler).”

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.

According to pharmacist T. Perryman, the errors he sees the most in the pharmacy setting “occurs when hospital made barcodes are being added to the medication rather than the medication having factory barcodes already present.” The process of standardizing all pharmaceutical drug

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

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.

Although, mistakes can best be prevented by designing the health system at all levels to make it safer to make it harder for people to do something wrong and easier for them to do it right (Andell, 2015). Developing and testing new technologies to reduce medical errors on a large-scale demonstrates projects to test safety interventions and error-reporting strategies (Andel, 2015). The barcode scanning system had a great impact on lowering the odds of an error reaching the patient. Additional things found in the study, that there were wrong dose, omissions, and communication errors that were considered as a “common error”. Overall, medication error rates decreased when there were pharmacist on duty at least 40 hours or more a week, and having the barcodes system support (Cochran et al.,

Although research has identified many flaws in the use of PMARs, this method of MA continues to be used by healthcare facilities. This issue if significant to nursing because medication errors cause patient harm can result in death and ultimately raise the cost of health (Seibert, Maddox, Flynn, & Williams, 2014). In an effort to provide safe and efficient care to patients, MA methods proven to be effective should be implemented in healthcare facilities.

The planned intervention in this study is to implement the barcodes medication system and evaluation the medication error rates, pre and post implementation. Observational nurses for the study will shadowed staff nurses on the units for 4 hours and, without knowing the physician's medication orders, recorded details about the medications being administered to patients (Poon et al., 2010). Implementing the BCMA system makes it conceivable for healthcare professionals to manage the patients through secure use, along with sharing of patient’s health care information (Health IT, 2014). The barcode medication system provides additional safety measure for patients and staff, while reducing error

Nursing in today?s society involves more than technical skills, critical thinking, and compassion. It also is changing to add the ability to not only understand but be able to utilize technology to impact a patient?s health. There are many technological changes employed in healthcare practices, however, I have chosen to address bar-code medication administration or BCMA. According to an article in the Journal of Patient Safety, ?bar-code medication administration has been shown to be effective in reducing patient medical errors, yet is still only utilized in 5% of the country?s health care facilities? (Sands, Slebodnik, & Young, 2010). Medication errors are common in hospitals and often lead not only to patient harm, but also lengthy hospital stays and law suits. ?One study identified 6.5 adverse events related to medication use per 100 inpatient admissions, more than one fourth of these events were due to errors and were therefore preventable? (Bane, et. al., 2010).

I learned about “Max” during my retail clinical in the spring. Max labels, counts, sorts, and caps all medications being dispensed. When sorting, it drops the bottle in the first letter of the patient’s last name. If the largest bottle in Max will not hold the full amount, it knows to use multiple bottles. This product maximizes your efficiency, supports 188 NDC numbers and automates up to 60% of your total prescription volume. It requires little up keep and will keep processing when you are replenishing medication or vials. Max is 100% accurate for drug and dose. How? Each of the cells have a unique barcode, which is scanned during restocking to ensure it is correct. The bottle of medication is also scanned and the NDC numbers have to match. Max has locking cells, which was designed for safety and to prevent diversion. They lock automatically when closed and can only be unlocked when an authorized user verifies a barcode match between the cell and the stock bottle. (Parata Max, n.d.) I feel this product is cost saving and saves time. The other things that I found interesting was that it will let you know if the prescription was incomplete. On the touch screen you can see that, it was not completed due to an undercount (cell empty). Finally, once a prescription is complete and you go to remove it from Max you must scan the barcode, this will then take that prescription out of the completed

The floor I recently worked on met a change in clinical practice when the supplies room was updated to an electronic scanning system. The new system requires staff to charge supplies to each patient by scanning item bar codes, which assigns and charges the item to the patient.

In the medical field, this has become known as BCMA, which is bar code-assisted medication administration. BCMA technology is being used as an aid to combat medication administration errors, improve patient safety and provide more accurate medication administration documentation. Not only is this technology being used in the United States, “however, this technology is also used in European countries including Denmark, Italy and the Netherlands” (Hassink, Jansen, Helmons, 2012). There have been many studies conducted over the years to conclude whether or not BCMA technology is advantageous to the medical field, including hospitals, doctors, nurses, and pharmacists’. Research has concluded, that there are both advantages and disadvantages when implementing BCMA technology, as well as contrasting information when it comes down to whether or not the BCMA technology is actually reducing errors in medicine administration. Although, the studies have concluded that there are many issues with BCMA technology, none indicate that BCMA technology is failing to prevent

adds thoroughness to the patient’s medical record for legal aspects. The newly installed badge readers were recently attached to all PCs located in physician workrooms. These devices allow the physicians the ability to place their badges onto the reader and it will instantly log them into the system. Another hardware device used by physicians is fingerprint readers. When physicians prescribe controlled substances, they place their finger onto the fingerprint to authenticate their identity and the prescription will be automatically routed to the patient’s pharmacy of choice. In the hospital clinics, cameras are used by access facilitators, (front desk support staff) to capture the patient’s photo and upload it into their chart. Physicians are able to view the photo when view the patient’s chart to help identify the patient.

While working at the Saskatoon Health Region to help implement a new computer system for the operating room I was given my own responsibility of making the inventory compatible with the computer system, I was told to be creative in how barcode the inventory and my manager said to come up with my own