Electronic Bar Coding and No Interruption Zones to Decrease Medication Errors

When it comes to medication errors several things may occur such as adverse drug event, unexpected deterioration, and even death in severe cases. AHRQ (2015) states, “an adverse drug event (ADE) is defined as harm experienced by a patient as a result of exposure to a medication, and ADEs account for nearly 700,000 emergency department visits 100,000 hospitalizations each year.” There are many ways that errors may occur such as dispensary errors, prescription errors

Assess patient’s environment like bed side rails, call lights within patient reach, allergic bands among other interventions established by the hospital as arm bands before administrating medication plus incorporating the using the barcode scanning system.

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).”

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

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 classroom, it is very important to have lab safety. In a hospital pharmacy, lab safety is essential to ensuring a safe dosage to each patient. Throughout my time interning as a pharmacist at the UVM Medical center, I was often observing how much pharmacists used DoseEdge software. DoseEdge automated system that assists the process of dose routing and preparation. This product of Baxter has allowed the tasks of pharmacy change. The focus of my project was “How does current and future technology affect efficiency and accuracy in pharmacy practice?”. Through my research of Baxter’s website, articles about their product, and reports of advancing technologies in pharmacy, I found that DoseEdge is very successful in productivity and safety in the workplace. Before DoseEdge, everything was required to be prepared by hand. This required a lot of responsibility for for pharmacists and technicians to make the correct dosage in the quickest manner. Medicine is very important to a hospital, so it is very important to have the most efficient way in preparing and distributing it. This allows pharmacist to have a better way of double-checking the preparation of drugs. In each IV hood, there is an overhead camera that takes pictures of what drug and how much of it the technician is using. Pharmacist can view multiple orders all by computer without the need of being physically next to the technician. There are also requirements to have two pharmacists check the same order for high risk drugs like chemotherapy. This

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

The following articles were reviewed for the purpose of addressing bar code scanning in medication administration. Nursing requires the critical skill of accurate medication administration. The use of electronic medication administration has brought about many changes in the healthcare field. The article,” What Determines Successful Implementation of Inpatient Information Technology Systems” (Spetz et al 2012), was reviewed to address the above question. Computerized patients records and bar-code medication systems continue to gain favor in healthcare. This idea spread across the nation in all VA sites (Spetz et al., 2012, p. 157), providing a safer environment for patient care.

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,

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.

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.

This paper will review the implementation of the Electronic Medication Administration Record (eMAR) at Clayton Memorial Hospital, a 420-bed hospital, with a regional cancer center, cardiovascular services, ambulatory services and 24 physician practices in West Palm Beach, Florida. Through implementation of the eMAR, the 5 rights of medication administration are maintained (right patient, right medication, right dose, right route and right time), notifications are at the nurse’s fingertips, errors and warnings are readily available, allergy checking is automatically done, dose checking and other applicable clinical data are accessible. This paper will discuss one hospital’s journey on the path to medication safety.

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).

Track and trace prescription drugs are an RFID application that can be used in the hospital. this application enables to electronically track and trace prescription drugs through specific product identifiers. The application will lead to long-term benefits by reducing medical errors, and saving time in the prescription drugs distribution. Brewin states that Dr. Jean-Pierre Garnier, CEO of pharmaceutical manufacturer GlaxoSmithKline PLC in London, said "long-term goal is the development of an electronic product code that will help track, trace and authenticate medicines through the whole distribution system." Also, it is not only about tracking the drug products, but also including information, such as expiration date and each point of contact for the drug from the manufacturer to the pharmacy. There will be a barcoded identification bracelet that is attached to each patient where the nurse will scan it to pull up the patient information. Then, it will compare the drug data with the patient’s prescription.

Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error