Effect of bar-code-assisted medication administration on medication administration errors and accuracy in multiple patient care areas

Abstract

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.

Bar Code Medication Administration Technology: A Systematic Review of Impact on Patient Safety When Used with Computerized Prescriber Order Entry and Automated Dispensing Devices

“…Of the 37 articles selected for full-text review, 5 met the inclusion criteria for evidence synthesis. Three of these studies used direct observation to determine medication errors, [10][11][12] whereas the other 2 studies relied on self-reporting. 13,14 Direct-observation studies are considered more reliable than those based on self-reporting 15 ; however, both types of data collection are commonly used in studies examining medication errors.…”

“…13,14 Direct-observation studies are considered more reliable than those based on self-reporting 15 ; however, both types of data collection are commonly used in studies examining medication errors. Three of the studies investigated the outcomes when BCMA technology was added to existing ADD and CPOE systems, 10,11,13 one study examined a setting where all 3 technologies were implemented at once, 12 and the final study investigated a setting where BCMA was added to existing ADDs, followed by implementation of CPOE.…”

“…17 One of the indicators, "two forms of identity not checked (orally confirming patient identity and scanning the bar code on the patient's wristband)", decreased from 13.4% to 6.9% (p < 0.0001) in the medical-surgical units. 11 However, the use of BCMA led to increases in distractions or interruptions (from 15.5% to 25.2%; p < 0.0001) and in medications given without explanation to the patient (from 10.9% to 14.9%; p = 0.045). 11 In the ICUs, none of the accuracy indicators improved after implementation of BCMA, except noncompliance with medication charting, which declined from 24.4% to 6.7% (p < 0.0001).…”

“…11 However, the use of BCMA led to increases in distractions or interruptions (from 15.5% to 25.2%; p < 0.0001) and in medications given without explanation to the patient (from 10.9% to 14.9%; p = 0.045). 11 In the ICUs, none of the accuracy indicators improved after implementation of BCMA, except noncompliance with medication charting, which declined from 24.4% to 6.7% (p < 0.0001). 11 Poon and others 10 were the only authors to conclude that BCMA reduces wrong time errors.…”

“…[10][11][12] Two of these studies concluded that BCMA reduced the absolute rate of nontiming errors by 4.6% 11 or 4.7%, 10 but their findings on timing-related medication administration errors were conflicting.…”