Increasing barcode medication administration (BCMA) to improve patient safety
Purpose: Medication errors frequently have catastrophic consequences for the patients, and place an enormous financial burden on our health care system. The Institute of Medicine Report, “To Err is Human” published in 1999, estimated that medication errors account for more than 7,000 deaths annually, and many of them are preventable. Errors may happen at different stages of the medication use process, but most commonly take place at the point of administration. Barcode medication administration (BCMA) technology requires the nurse to scan the patient’s wrist band to ascertain the correct patient, and the medication barcode, to verify the right medication, dose, route and time, which are recognized as the “Five Rights” of medication administration. BCMA implementation has demonstrated to significantly reduce errors at the point of administration. The Leapfrog Group, a national organization and coalition of public and private purchasers of employee health coverage has developed a national standard for BCMA which requires both, patient and medication scans in 95% of medication administrations in units where this technology has been implemented. The purpose of this study was to increase the rate of patient and medication scanning to meet the Leapfrog standard.
Methods: A prospective review of medication and patient scanning compliance was conducted for a 16 month period from January 2018 to April 2019. Two computer reports were generated monthly. One report was used to identify the number of medication doses administered and the percentage of medications and patients scanned by hospital unit. The second report was used to identify the medications and patients not scanned, and staff members scanning less than 50% of the medications or patients. Each unit leader was provided instructions on how to generate the scanning report for their area. Compliance data was presented to the hospital leadership and to the Medication Safety Committee where barriers to compliance were identified and discussed. Committee members were tasked with disseminating the information and educating the staff. Areas of the hospital with low scanning rates were toured, and opportunities for improvement were identified and addressed. Targeted one-on-one education was provided to staff members with low compliance.
Findings: During the study period a total of 1,035,951 medications doses were administered. Hospital-wide medication and patient scanning compliance increased from 82% to 92% and from 83% to 93% respectively, resulting in a 12% improvement in the process or 124, 314 additional doses scanned. Barriers to scanning identified included insufficient number of scanners in the Emergency Department and medication barcodes not scanning properly.
Discussion/Conclusions: Barcode medication scanning is a safety measure that has shown to reduce medication errors at the point of administration. Interventions such as raising awareness of the importance of this measure, securing leadership support, targeted individual staff education, and identifying and addressing barriers to scanning are tools that can be successfully implemented to in-crease compliance.
Implications for Practice: 1. Medication errors can have catastrophic consequences for patients and place a huge financial burden on healthcare systems. 2. Barcode medication administration can reduce medication errors.
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Perez Arias, Maria, "Increasing barcode medication administration (BCMA) to improve patient safety" (2019). All Publications. 3288.