Abstract
Barcode medication administration (BCMA) is advocated as a technology that reduces medication errors relating to incorrect patient identity, drug or dose. Little is known, however, about the impact it has on nursing workflow. Our aim was to investigate the impact of BCMA on nursing activity and workflow. A comparative study was conducted on two similar surgical wards within an acute UK hospital. We observed nurses during drug rounds on a non-BCMA ward and a BCMA ward. Data were collected on drug round duration, timeliness of medication administration, patient identification, medication verification and general workflow patterns. BCMA appears not to alter drug round duration, although it may reduce the administration time per dose. Workflow was more streamlined, with less use of the medicines room. The rate of patient identification increased from 74% (of 47) patients to 100% (of 43), with 95% of 255 scannable medication doses verified using the system. This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration. There was reduced variability in the medication administration workflow of nurses, along with an increased patient identification rate and high medication scan rate, representing potential benefits to patient safety.
Highlights
Barcode medication administration (BCMA) involves scanning a patient’s unique barcode and medication barcodes to verify that these are correct before proceeding to administer a dose
This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration
Seven different nurses were were observed on the non-BCMA ward, and eight on the BCMA ward
Summary
Barcode medication administration (BCMA) involves scanning a patient’s unique barcode and medication barcodes to verify that these are correct before proceeding to administer a dose. It is becoming more common in many countries, often integrated with electronic prescribing and medication administration (ePMA) systems [1]. BCMA is reported as having a number of patient safety benefits, including a reduction in both the rate and severity of medication administration errors [2,3,4,5]. It has been proposed that if BCMA systems hinder nurses’ workflow, workarounds occur that may reduce effectiveness in practice; these include actively bypassing key steps, such as placing a patient’s barcode on another object for easier scanning [8,9]. Results from direct observation studies suggest the time nurses spend on medication administration tasks can remain the same or reduce, and the Pharmacy 2020, 8, 148; doi:10.3390/pharmacy8030148 www.mdpi.com/journal/pharmacy
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