Implementation of Bar Code Medication Administration in an Emergency Department Setting

18.00
Hdl Handle:
http://hdl.handle.net/10755/324151
Category:
Abstract
Type:
Presentation
Title:
Implementation of Bar Code Medication Administration in an Emergency Department Setting
Author(s):
Brown, Jacqueline
Author Details:
Jacqueline Brown, MS, RN, email: jacqueline.brown@providence.org
Abstract:
Evidence-based Practice Abstract Purpose: Serious medication errors occur in hospitals resulting in significant patient morbidity and mortality. These errors frequently involve administration of incorrect drugs and incorrect doses. Bar-code-assisted medication administration (BCMA) technology significantly reduces medication administration errors by improving compliance with checking the “five rights” of medication administration: right patient, right drug, right dose, right route and right time. Although BCMA is frequently used in the inpatient setting, it has not been adopted in the emergency department (ED) setting. The purpose of this project was to implement BCMA technology (scanner, computer software and bar coded unit dose medication packaging) in the ED setting to reduce medication errors and improve patient safety. Design: An interdisciplinary team implemented BCMA technology in the ED in conjunction with the implementation of computerized physician order entry (CPOE). Setting: A level III trauma/emergency department with an annual volume of 65,000 patients. Participants/Subjects: Emergency department nursing staff utilizing BCMA technology on patients admitted to the ED who received a medication as part of their care. Methods: To prepare for the advent of a BCMA system, an interdisciplinary team formulated the implementation plan. This plan included: 1) Development of new workflow to support BCMA; 2) Identification of type and placement of new equipment/technology (e.g. scanners and computers); 3) Attachment of bar codes by Pharmacy to all medications; 4) Training of nursing staff - 2 hours of didactic training in medication scanning; 5) Hands-on support from super-users for 4 weeks following implementation, 6) Established expectations for staff use of bar code scanning with increased compliance expected monthly; 7) Posting of individual nurse compliance to encourage a sense of competitiveness among nursing staff. Results/Outcomes: In the ED setting, it is not always feasible to use BCMA during all situations (e.g. codes and procedural sedation). With this in mind, the expectation for compliance with the use of BCMA technology was set at 75%. Currently approximately 90% of the staff uses BCMA 80% of the time when administering medications. The wrong medication was scanned by nursing staff approximately 100 times a month. Unfortunately this number is deceptive as it includes when a medication concentration is scanned that does not match the physicians order. This is frequently related to a system issue as we work to build medication lists in our new computerized documentation system. However, there is still value in having the BCMA identify a “wrong medication” as it requires the nursing staff to double check that they have the correct medication. Approximately 10 times each month, a medication was scanned for one patient when it was actually ordered for another patient. In this instance, use of BCMA has demonstrated a clear reduction in medication errors. Implications/Learnings: A BCMA system can be implemented successfully in an emergency department setting. Factors important to the success of implementation include: leadership support, interdisciplinary team involvement including nursing staff that will use BCMA technology, adequate equipment/technology at the point of service, and adequate training and rollout support.
Keywords:
Bar Code Med Administration
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImplementation of Bar Code Medication Administration in an Emergency Department Settingen_GB
dc.contributor.authorBrown, Jacquelineen_GB
dc.author.detailsJacqueline Brown, MS, RN, email: jacqueline.brown@providence.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324151-
dc.description.abstractEvidence-based Practice Abstract Purpose: Serious medication errors occur in hospitals resulting in significant patient morbidity and mortality. These errors frequently involve administration of incorrect drugs and incorrect doses. Bar-code-assisted medication administration (BCMA) technology significantly reduces medication administration errors by improving compliance with checking the “five rights” of medication administration: right patient, right drug, right dose, right route and right time. Although BCMA is frequently used in the inpatient setting, it has not been adopted in the emergency department (ED) setting. The purpose of this project was to implement BCMA technology (scanner, computer software and bar coded unit dose medication packaging) in the ED setting to reduce medication errors and improve patient safety. Design: An interdisciplinary team implemented BCMA technology in the ED in conjunction with the implementation of computerized physician order entry (CPOE). Setting: A level III trauma/emergency department with an annual volume of 65,000 patients. Participants/Subjects: Emergency department nursing staff utilizing BCMA technology on patients admitted to the ED who received a medication as part of their care. Methods: To prepare for the advent of a BCMA system, an interdisciplinary team formulated the implementation plan. This plan included: 1) Development of new workflow to support BCMA; 2) Identification of type and placement of new equipment/technology (e.g. scanners and computers); 3) Attachment of bar codes by Pharmacy to all medications; 4) Training of nursing staff - 2 hours of didactic training in medication scanning; 5) Hands-on support from super-users for 4 weeks following implementation, 6) Established expectations for staff use of bar code scanning with increased compliance expected monthly; 7) Posting of individual nurse compliance to encourage a sense of competitiveness among nursing staff. Results/Outcomes: In the ED setting, it is not always feasible to use BCMA during all situations (e.g. codes and procedural sedation). With this in mind, the expectation for compliance with the use of BCMA technology was set at 75%. Currently approximately 90% of the staff uses BCMA 80% of the time when administering medications. The wrong medication was scanned by nursing staff approximately 100 times a month. Unfortunately this number is deceptive as it includes when a medication concentration is scanned that does not match the physicians order. This is frequently related to a system issue as we work to build medication lists in our new computerized documentation system. However, there is still value in having the BCMA identify a “wrong medication” as it requires the nursing staff to double check that they have the correct medication. Approximately 10 times each month, a medication was scanned for one patient when it was actually ordered for another patient. In this instance, use of BCMA has demonstrated a clear reduction in medication errors. Implications/Learnings: A BCMA system can be implemented successfully in an emergency department setting. Factors important to the success of implementation include: leadership support, interdisciplinary team involvement including nursing staff that will use BCMA technology, adequate equipment/technology at the point of service, and adequate training and rollout support.en_GB
dc.subjectBar Code Med Administrationen_GB
dc.date.available2014-08-04T13:28:26Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:26Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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