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HEIN A. VAN ONZENOORT, PHARM.D., is Resident Pharmacist, Department of Clinical Pharmacy and Toxicology; AFKE VAN DE PLAS, PHARM.D., is Hospital Pharmacist, Department of Clinical Pharmacy and Toxicology; ALFONS G. KESSELS, M.SC., is Methodologist, Department of Clinical Epidemiology and Medical Technology Assessment; and NICOLE M. VELDHORST-JANSSEN, PHARM.D., is Hospital Pharmacist, Department of Clinical Pharmacy and Toxicology, University Hospital Maastricht, Maastricht, Netherlands. PAUL-HUGO M. VAN DER KUY, PHARM.D., PH.D., is Hospital Pharmacist and Clinical Pharmacologist, Department of Clinical Pharmacy, Maaslandziekenhuis, Sittard, Netherlands. CEES NEEF, PHARM.D., is Professor in Clinical Pharmacy, Department of Clinical Pharmacy and Toxicology, University Hospital Maastricht.

Address correspondence to Dr. van Onzenoort at the Department of Clinical Pharmacy and Toxicology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, Netherlands (hvon{at}kfls.azm.nl).

Purpose. Factors influencing the bar-code verification by nurses during medication administration in a Dutch hospital were studied. Summary. The use of bar-code verification during medication administration in five medical departments was recorded daily for three weeks. These data were collected via electronic medication administration records. The frequency of bar-code verification was calculated as a percentage of all administrations, corrected for the availability of bar-coded packages. Nurses were asked why bar-code verification was not always used. A total of 23,492 medication administrations were recorded, 15,162 (64.5%) of which required bar-code verification. Bar-code verification was significantly influenced by the medical department, deviation between prescribed and administered times, administration route of the drug, number of nurses available in each department, and age of the nurse. The five most cited reasons for not verifying bar codes were difficulties in scanning bar codes on the medication labels, lack of awareness of bar codes on medication labels, delays in responses from the computerized system, shortage of time, and administration of medication before prescription. Conclusion. Nurses verified the bar codes of only about half of medications administered to patients. Various factors influenced the frequency of bar-code verification by nurses except the number of medications administered. More education regarding medication safety is warranted to increase compliance to a bar-code-enabled point-of-care system. Index terms: Codes; Drug administration; Hospitals; Nurses; Quality assurance

 

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