Barcode Medication Administration Technology Research Articles

Raising the barcode: improving medication safety behaviours through a behavioural science-informed feedback intervention. A quality improvement project and difference-in-difference analysis

Barcode medication administration (BCMA) technology can improve patient safety by using scanning technology to ensure the right drug and dose are given to the right patient. Implementation can be challenging,...

Implementation of barcode medication administration (BMCA) technology on infusion pumps in the operating rooms

BackgroundMedication administration errors (MAEs) are a major cause of morbidity and mortality. An updated barcode medication administration (BCMA) technology on infusion pumps is implemented in the operating rooms to automate...

Barcode Medication Administration Technology to Prevent Medication Errors.

Medication errors cause harm to patients at any point along the medication administration process and can be prevented. Barcoding medication administration (BCMA) is effective as a clinical decision support system (CDSS) to avoid errors. This viewpoint proposes the implementation of BCMA to avoid potential adverse events. The opinion piece gives an overview of BCMA, reviews the current literature on its effectiveness, and sheds light on the associated challenges and how to overcome them. The objective of this article is to increase awareness regarding BCMA and how it can decrease patient morbidity and mortality, enhance safety, and lower overall hospital-associated costs by preventing medication errors. Key Words: Bar-code medication administration, Medication errors, Adverse drug events, Patient safety.

Barcode Medication Administration Technology to Prevent Medication Errors.

Medication errors cause harm to patients at any point along the medication administration process and can be prevented. Barcoding medication administration (BCMA) is effective as a clinical decision support system (CDSS) to avoid errors. This viewpoint proposes the implementation of BCMA to avoid potential adverse events. The opinion piece gives an overview of BCMA, reviews the current literature on its effectiveness, and sheds light on the associated challenges and how to overcome them. The objective of this article is to increase awareness regarding BCMA and how it can decrease patient morbidity and mortality, enhance safety, and lower overall hospital-associated costs by preventing medication errors. Key Words: Bar-code medication administration, Medication errors, Adverse drug events, Patient safety.

Sustained barcode medication administration rates less than 2 percent in a large healthcare system

Purpose Implementation of bar code medication administration (BCMA) technology is an effective strategy to decrease medication administration errors. Consistent use of BCMA technology within a hospital system should result in improved patient safety through the reduction of medication related administration errors. Based on this premise, a large health system established an annual goal to reduce BCMA override rates to less than 2%. Methods A large health system located in the Intermountain West developed a BCMA override reporting tool to assist with reducing BCMA override rates. An essential component of the reporting tool is the visual management strategy which allows caregivers to easily identify goal progress. The tool also includes information that managers can use to determine how often their direct reports override medications. Pharmacy caregivers can also use the data from the reporting tool to address specific issues related to medications that do not scan properly. Results Implementation of the tool and education on its use, resulted in individual follow up with nursing units and nurses, ultimately producing sustained barcode overrides less than 2%. Conclusion By implementing reporting systems that identifies specific opportunities for improvement, barcode override rates can be decreased to less than 2% in a large healthcare system.

Barcode Medication Administration Software Technology Use in the Emergency Department and Medication Error Rates.

High-quality care during and after a medication process requires complete and accurate medication administration documentation. Veterans Affairs Medical Centers use barcode medication administration technology to document medication administered to Veterans throughout the inpatient and long-term care areas of the hospital. Barcode medication administration has demonstrated a reduction in medication administration errors; however, it is not commonly used in Veterans Affairs Medical Center clinical areas or emergency departments. During this study, only 39% of the recorded 165 Veterans Affairs Medical Centers that use barcode medication administration technology in their inpatient areas stated that barcode medication administration was also used in clinical areas of the hospital. Of these facilities, only 14% had implemented barcode medication administration in their emergency department. This study evaluated medication error rates before and after barcode medication administration technology was implemented in the emergency department of a Veterans Affairs Medical Center located in the Southeastern region of the United States. A total of 258 charts, 129 before and 129 after barcode medication administration technology implementation in the emergency department, were reviewed for Veterans who were evaluated and ordered to receive medication in the emergency department before transferring to an inpatient unit at the Veterans Affairs Medical Center where this study was conducted. A quantitative nonexperimental descriptive comparison demonstrated a 10.8% reduction in medication error rates and 21% reduction in the average number of medications given in error per chart after barcode medication administration technology was implemented in the emergency department. In addition to the study outcome, a potentially unsafe workaround was identified. Stakeholders that use barcode medication administration technology in their emergency departments would benefit from assessing the association between barcode medication administration use and medication administration error rates. However, assessing whether barcode medication administration technology remains useful and continues to provide safe medication administration practices for our Veterans is also recommended.

Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations

IntroductionBarcode medication administration (BCMA) can, if poorly implemented, cause disrupted workflow, increased workload and cause medication errors. Further exploration is needed of the causes of BCMA policy deviations.ObjectiveTo gain an...

Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology?

BackgroundIn order to reduce safety risks associated with medication administrations, technologies such as barcode medication administration (BCMA) are increasingly used. Examining how human factors influence adoption and usability of this...

THE IMPACT OF BARCODE MEDICATION ADMINISTRATION ON PATIENT SAFETY: A SYSTEMATIC REVIEW

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety.
 Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure.
 This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies.
 The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration.
 Keyword: Patient Safety, Impact, BCMA, eMAR

Emergency Department Nurses Attitudes Toward Barcode Medication Administration

Abstract
 Background: Barcode medication administration (BCMA) has been widely implemented in the inpatient setting of hospitals throughout the United States, resulting in lower medication administration errors. Understanding nurses’ attitudes toward BCMA in the Emergency Department (ED) may assist administrators with creating implementation strategies that will improve medication administration process turnaround time and remove barriers to use ensuring increased compliance and improved patient safety.
 Methods: The aim of this descriptive research study was to identify Emergency Department nurses’ attitudes towards acceptance of this technology, based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Data collection was carried out using an online, cross-sectional survey of nurses (n=55) who were members of the National Emergency Nurses Association of Canada.
 Results: The results demonstrated that two-thirds of those surveyed had approximately one year of experience with using BCMA technology. More positive attitudes were found in the following domains: behavioral intent, anxiety, and self-efficacy. Neutral attitudes were perceived regarding facilitating conditions, social influence, and effort expectancy. The most negative attitudes were expressed regarding attitude toward technology and performance expectancy.
 Conclusions: The results of this study allow us to conclude that the ED nurse perceived BCMA as easy to master and use and not intimidating or anxiety producing; however, they do not perceive it as useful nor do they perceive it to improve their proficiency or productivity. It is recommended that future studies be conducted on larger samples and also on participants that have had more experience using this technology.
 Keywords: Barcode Medication Administration, Emergency Department, Medication Administration, Attitudes.
 

Nurses' Compliance With Bar-code Medication Administration Technology

Medication administration using bar-code medication administration technology enhances the verification of medication administration rights. Nurses' compliance with bar-code medication administration procedure is essential to maximize the benefits. This study evaluated the current rate of nurses' compliance with bar-code medication administration use through direct observation. A descriptive design was used and 134 RNs were recruited from two public hospitals located in the middle region of Jordan. Compliance with bar-code medication administration was evaluated using an evidence-based checklist of 17 items. Participants' compliance with the bar-code medication administration was 55%, which had a significant positive correlation with their level of comfort using bar-code medication administration, usefulness, and ease of use, perceived job productivity, and overall rating of bar-code medication administration. Stakeholders can benefit from assessing end-user acceptance and perceptions regarding the bar-code medication administration technology to promote acceptance and compliance.

Nurses' satisfaction with barcode medication-administration technology: Results of a cross-sectional study.

Medication administration is a critical task of nurses that, if not done appropriately, can lead to fatal errors. New technologies, including barcode medication administration, are intended to decrease medication errors and enhance verification of medication-administration rights. Therefore, in this study, we examined the effect of introducing barcode medication administration on nurses' satisfaction and identified correlates of nurses' satisfaction with barcode medication administration. A descriptive, cross-sectional design using self-reported questionnaires was utilized to recruit 207 nurses from three public hospitals. Participants reported being moderately satisfied with barcode medication administration, especially with its efficacy and safety aspects. Their satisfaction had a significant negative correlation with their age, nursing experience, and experience using barcode medication administration, and a significant positive correlation with barcode medication-administration training satisfaction, computer competence, comfort with using barcode medication administration, and perceived job productivity using barcode medication administration. This study provides important information about Jordanian nurses' satisfaction with barcode medication-administration technology and provides greater understanding of different clinical correlates to barcode medication-administration satisfaction. It is recommended that effective barcode medication-administration training and computer skills training be provided prior to establishing barcode medication administration in hospitals and that the safety features of barcode medication administration be integrated in clinical education and training.

Understanding Mental Health Nurses’ Perceptions of Barcode Medication Administration: A Qualitative Descriptive Study

Barcode medication administration (BCMA) technology has been challenging for mental health nurses to incorporate into their clinical practice despite the potentially positive benefits of using the technology for improving patient safety. A review of the literature identified a number of practices that nurses can use to improve adoption of the technology, however, these practices have been primarily used in non-mental health contexts. Therefore, the purpose of this study was to understand mental health nurses’ perceptions of practices identified from the literature to improve BCMA adoption in a mental health inpatient setting. Using a qualitative descriptive approach, ten (n = 10) interviews were conducted with direct care mental health nurses working at a mental health and addiction academic teaching hospital in Canada. Data analysis consisted of a conventional content analysis of the interview transcripts by two independent coders. The following five themes emerged from the transcripts: 1) safety, 2) clinical workflow, 3) education, 4) accountability, and 5) strategies. Sub-themes were also identified within the themes of safety and clinical workflow. Insights gleaned from this study warrant acknowledgement and consideration when implementing strategies to increase BCMA compliance within mental health contexts.

Implementation of Bar-Code Medication Administration to Reduce Patient Harm.

ObjectiveTo assess the impact of implementing bar-code medication administration (BCMA) technology on the rate of medication administration errors in the inpatient setting, specifically those that affect the patient and result in harm.Patients and MethodsImplementation of the new technology began in September 2008 in a staged rollout of 4 or 5 units at a time in 11 separate waves. All corresponding medication administrations and voluntarily reported medication-related adverse events from March 1, 2007, through September 30, 2013, were included for analyses. Adherence to the use of BCMA technology and the number of adverse events were tracked and compared across the preimplementation period through follow-up. Actual errors, not potential errors, were included in the analysis.ResultsAfter the BCMA technology was introduced, reported medication administration errors decreased by 43.5%. More importantly, the rate of harmful medication errors decreased from 0.65 per 100,000 medications preintervention to 0.29 per 100,000 medications postintervention. This resulted in a 55.4% decrease in actual patient harm events. None of the errors at category E or higher was caused by BCMA factors.ConclusionConsistent use of BCMA technology improves patient safety by decreasing the number of patients harmed by medication administration errors.

A Retrospective and Commentary on FDA’s Bar Code Rule

Food and Drug Administration (FDA) published a final regulation in 2004 that requires pharmaceutical manufacturers to place linear bar codes on certain human drug and biological products. The intent was that bar codes would be part of a system where healthcare professionals would use bar code scanning equipment and software to electronically verify against a patient’s medication regimen that the correct medication is being given to the patient before it is administered, which could ultimately reduce medication errors. In the 2004 prospective regulatory impact analysis, FDA anticipated that the rule would stimulate widespread adoption of bar code medication administration technology among hospitals and other facilities, thereby generating public health benefits in the form of averted medication errors. FDA estimated that annualized net benefits would be $5.3 billion. In this retrospective analysis, we reassess the costs and benefits of the bar code rule and our original model and assumptions. Employing the most recent data available on actual adoption rates of bar code medication administration technology since 2004 and other key determinants of the costs and benefits, we examine the impacts of the bar code rule since its implementation and identify approaches to improve the accuracy of future analyses. In this retrospective study, we use alternative models of health information technology diffusion to create counterfactual scenarios against which we compare the benefits and costs of the bar code rule. The magnitudes of the costs and benefits of the 2004 rule are sensitive to assumptions about the counterfactual technology adoption rate, with the upper-bound range of calculated annualized net benefits between $2.7 billion and $6.6 billion depending on the baseline scenario considered.Disclaimer: The findings, interpretations, and conclusions expressed in this article are those of the authors in their private capacities, and they do not represent the views of the Food and Drug Administration.

Factors Associated With Barcode Medication Administration Technology That Contribute to Patient Safety: An Integrative Review.

In an effort to prevent medication errors, barcode medication administration technology has been implemented in many health care organizations. An integrative review was conducted to understand the effect of barcode medication administration technology on medication errors, and characteristics of use demonstrated by nurses contribute to medication safety. Addressing poor system use may support improved patient safety through the reduction of medication administration errors.

Thank you for asking: Exploring patient perceptions of barcode medication administration identification practices in inpatient mental health settings

BackgroundBarcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings. If barcode medication administration technology is to be effectively used in this context, healthcare organizations need to understand patient preferences with regards to identification methods. PurposeThe purpose of this study was to elicit patient perceptions of barcode medication administration identification practices in inpatient mental health settings. Insights gathered can be used to determine patient-centered preferences of identifying patients using barcode medication administration technology. MethodsUsing a qualitative descriptive approach, fifty-two (n=52) inpatient interviews were completed by a Peer Support Worker using a semi-structured interview guide over a period of two months. Interviews were conducted in a number of inpatient mental health areas including forensic, youth, geriatric, acute, and rehabilitation services. An interprofessional team, inclusive of a Peer Support Worker, completed a thematic analysis of the interview data. ResultsSix themes emerged as a result of the inductive data analysis. These included: management of information, privacy and security, stigma, relationships, safety and comfort, and negative associations with the technology. Patients also indicated that they would like a choice in the type of identification method used during barcode medication administration. As well, suggestions were made for how barcode medication administration practices could be modified to become more patient-centered. ConclusionThe results of this study have a number of implications for healthcare organizations. As patients indicated that they would like a choice in the type of identification method used during barcode medication administration, healthcare organizations will need to determine how they can facilitate this process. Furthermore, many of the concerns that patients had with barcode medication administration technology could be addressed through patient education.

Bar Code Medication Administration Technology: A Systematic Review of Impact on Patient Safety When Used with Computerized Prescriber Order Entry and Automated Dispensing Devices.

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Integrating Bar-Code Medication Administration Competencies in the Curriculum

This article describes an innovative project involving the integration of bar-code medication administration technology competencies in the nursing curriculum through interprofessional collaboration among nursing, pharmacy, and computer science disciplines. A description of the bar-code medication administration technology project and lessons learned are presented.

Effect of the Implementation of Barcode Technology and an Electronic Medication Administration Record on Adverse Drug Events.

Hospitals have attempted to reduce adverse drug events (ADEs) by investing in new technologies, but data regarding their efficacy are lacking. This study evaluates the effects of the implementation of barcode medication administration (BCMA) and electronic medication administration record (eMAR) technology on the profile of ADEs in a hospital setting. We conducted a before-and-after study examining the effects of the implementation of BCMA and eMAR technology on the profile of ADEs at a 400-bed academic medical center by using incident reports. We compared reported ADEs in pre- and post-implementation periods of 5 months to determine whether there was a reduction in the rate of ADEs within medication use phases. We further examined the severity of errors and described changes in the distribution of types of errors. A total of 775 electronic error-reporting system reports were included in this study: 397 (51%) in the pre-implementation period and 378 (49%) in the post-implementation period. The rate of ADEs significantly decreased from 0.26% to 0.20% after implementation of the technology (relative risk [RR], 0.78; 95% CI, 0.67-0.89). The rate of transcription errors decreased from 0.089% to 0.036% (RR, 0.40; 95% CI, 0.30-0.54), which was largely attributed to reduction of "wrong time" errors. The rate of administration errors was identical in both groups at 0.017% (RR, 0.98; 95% CI 0.58-1.66). The mean severity level of administration errors significantly decreased from 4.44 to 3.23 (p = .005). The implementation of eMAR and BCMA technology improved patient safety by decreasing the overall rate of ADEs and the rate of transcription errors. These technologies also reduced the harmful impact to patients caused by administration errors.