Bar-Code-Assisted Medication Administration

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).”

According to Rosseter (2011), one of the largest segments of the US workforce are comprised of Registered Nurses, with over three million registered nurses worldwide. Due to the fast paced and rising complex demands placed on our healthcare environment, it is no surprise that over twenty-four thousand post graduate students were actively seeking and earning their master’s degree in nursing in 2011 (DHHS, 2013, p.ix). In order to gain an understanding of the interplay among my education, career path and opportunities afforded to me by taking an approach to higher degree learning. I approached a co-worker whose capabilities impressed me and asked her five questions in person, in order to gain her insightful information of what I will be facing during these next few months.

Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/

One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis. Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication errors in this organization to ensure patient safety.

* Reduction of medication errors- Barcode medication administration safeguards against wrong pt/wrong med/wrong dose errors and alerts to potential medication interactions (Goth, 2006).

Outcome measures assess whether the interventions to improve medication safety practice will be successful. During the interview of the new employee, competency evaluation related to medication administration will be applied first. In addition, during the orientation for these new employees, adequate training will be provided to ensure the importance of preventing medication errors. They will be given a list of similar and look-alike medications and will focus on medications that cause the most adverse reactions when errors may occur. Then, after training and when staff start working, they will be supervised during their first few months. When they are not supervised, they will be assessed and evaluated for any errors. During this process,

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

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.

Annie, the hospital I work at also uses a bar scanning process to scan all medications prior to administration. This helps cut down on medication errors. As you stated, I believe there are times when medications are not scanned prior to administration, in such cases as: cardiac arrests, hypoglycemic patients, and opiate overdoses. Prior to scanning the patient, there is still other verification methods used. We must always check the five rights of medication administration, these include: checking the armband for right patient, right drug, right dose, right route, and right time. Having this evidence-based practice of barcode scanning implemented lessens the chances for medication errors with improves the quality of health care. Quality

Bar code medication administration system is not currently in use at her clinics, do to the fact they do not have a Pyxis or similar type of machine and that their formula of medications in which they can give it limited. They also do not dispense any type of narcotics.

The safety of the patient is very crucial when caring for patients and the community. The use of informatics would improve Patient safety, such as the use of medication barcode administration, (BCMA), and Computerized Provider Order Entry (CPOE) are few informatics implementations that would help with patient safety in the healthcare system (Sewell, 2015) Cost is another driving force towards the use of informatics. With the cost of health at its highest, consumers and employers would use informatics to access the quality of care, compare prices and also compare providers. Medical errors in healthcare setting cost a hugged amount of money. “Electronically prescribed drugs are more legible, thus making it less likely that drugs would be wrongly administered to patients (Chih-Piing et al, 2016)”.The use of informatics will help reduce some of this error which would save the government, hospital, and consumers from extremely high

In today’s current fast-paced and demanding field of heath care, medication administration has become complex and time-consuming task. Approximately one-third of the nurses’ time is used in medication administration. There is much potential for error because of the complexity of the medication administration process. Since nurses are the last ones to actually administer the medication to the patient therefore they become responsible for medication administration errors (MAE). Reasons for MAE may include individual factors, organizational factors or system factors. This paper will discuss the root causes analysis of MAE and strategies to prevent them.

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when

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).

There are many ways that health care informatics has improved patient safety. One example includes having Electronic Medical Records (EMRs).These EMRs have greatly improved patient safety including notifications for allergies, clear and organized notes from other health care providers, and the elimination of misinterpreting physician orders based on illegibility. Another example is the barcode on the backs of all medication to ensure nurses are administering the correct medication and the right dose to the right patient. This has improved patient safety by reducing medication errors by using barcodes as an additional safety check during the medication administration process.