Copyright © 2009. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00
Practice Reports |
Effect of bar-code-assisted medication administration on medication administration errors and accuracy in multiple patient care areas
PIETER J. HELMONS, PHARM.D., is Pharmacoeconomics Specialist, Department of Pharmacy, University of California San Diego (UCSD) Medical Center, San Diego; at the time of this study he was a Postdoctoral Fellow, UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla. LINDSAY N. WARGEL, PHARM.D., is Clinical Pharmacist, UCSD Medical Center; at the time of this study she was Postgraduate Year 1 Resident, Department of Pharmacy, UCSD Medical Center. CHARLES E. DANIELS, PH.D., is Professor of Clinical Pharmacy and Associate Dean for Clinical Affairs, UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, and Pharmacist-In-Chief, Department of Pharmacy, UCSD Medical Center.
Address correspondence to Dr. Helmons at the University of California San Diego Medical Center, 200 West Arbor Drive, Mail Code 8765, San Diego, CA 92103-8765 (phelmons{at}ucsd.edu).
Methods. This prospective, before-and-after, observational study was conducted in two medical–surgical units, one medical intensive care unit (ICU), and one surgical ICU of a 386-bed academic teaching hospital. Nursing staff were observed administering medications one month before and three months after implementation of BCMA technology. Observations were conducted by two pharmacists and four pharmacy students on weekdays and weekends. Medication administration accuracy was measured using the accuracy indicator of the California Nursing Outcomes Coalition.
Results. The majority of medication administrations occurred during the 9 a.m. medication round. After BCMA implementation in the medical–surgical units, improved adherence to patient identification policies was observed, but more distractions of the nursing staff occurred and the medications administered were less frequently explained to the patient. Although an increase in wrong-time errors was observed in the medical–surgical units, the total number of medication errors did not change. When wrong-time errors were excluded, the rate of medication errors decreased by 58%. In the ICUs, the charting of medication administration improved after BCMA implementation, but total medication errors and wrong-time errors did not change.
Conclusion. Implementing BCMA technology decreased medication administration errors in medical–surgical units but not in ICUs when time errors were excluded. BCMA technology affected different types of medication administration errors in different patient care areas.
Index terms: Codes; Drug administration; Errors, medication; Hospitals; Quality assurance; Technology
Read all eLetters
Purpose. The effect of a commercially available bar-code-assisted medication administration (BCMA) technology on six indicators of medication administration accuracy and nine types of medication administration errors in distinct patient care areas were studied.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
eLetters: