Impact of the Bar Code Medication Administration System on Patient Safety
Kelly Reese, R.N.
May 6, 2011
According to The Institute of Medicine, there are more than a million injuries and almost 100,000 deaths associated with medication administration errors every year in the healthcare industry. Since medication administration is a major nursing duty, it is the nurse's responsibility to prevent medication errors to ensure patient safety. The large amount of medication errors has prompted the healthcare industry to research a solution to this serious problem. In 2000, a Veterans Administration hospital became the first hospital to utilize the Bar Code Administration System (BCMA) which assist in identifying the right patient to the right medication. The implementation of the BCMA has proved to greatly reduce the number of medication administration error, improve patient outcomes, and increase nurse’s job satisfaction.
“As an intervention, medication administration had the second greatest frequency of all interventions, trailing only active listening” (Doyle, 2005). Accurate patient identification is essential to nursing practice especially when administering medications. Nurses use the three checks of the “five rights” of medication administration including the right patient, dose, route, time, and frequency before administering medications. Nurses administer multiple medications to multiple patients many times during a shift. Because of the increasing acuity of patients and the increasing patient load on one nurse, this process is very error-prone. During one clinical rotation I had three patients and each patient had at least seven medications due in one hour. This could lead to horrific consequences. Even with this standard process there are great opportunities for mistakes.
With the increasing number of medication administration errors and sentinel events due to these mistakes, the healthcare community recognized a need to somehow improve the medication administration process. To improve the process of medication administration, new technological advances have come about with the implementation of the BCMA system. Each patient receives a wristband with a bar code specific to that patient and each medication with the specific dose also has a bar code. After the nurse receives the medication from the Pyxis or from the pharmacy, the nurse completes her three checks of the “five rights” and then proceeds with using the BCMA system. The nurse enters the patient's room with the hand-held scanner and the medications. She then scans the patient's identification bracelet and asks the patient two patient identifiers, such as name, date of birth, or the spelling of their name. After accurate patient identification, the nurse scans each individual medication to be administered. The handheld scanner will recognize each medication and make sure it is the right dose, time, and route to the correct patient. According to Hughes and Blegen, many research studies have shown large reductions in medication errors, as much as a 79 percent drop in administration errors (2008).
“A prospective cohort study of medication errors by Leape et al determined that 39% if errors occur during the prescribing phase, 12% during transcription, 11% during dispensing, and 38% during administration (“Medication Errors,” 2008). The BCMA helps identify the right patient to the right medication; however, there are several steps in the process before using the BCMA system that are prone to errors. The prescriber can select the wrong drug, dose, or route which may or may not be noticed by the nurse that is administering it; however, it is the nurse's duty to recognize inaccurate orders based on her knowledge and skills that no computer would notice. Problems can also...