Oops I Did It Again: Preventing Medication Errors Using BCMA

1. Oops I Did It Again: Preventing Medication Errors Using BCMA Elvire Dupoux, Melissa Pruitt, and Daniel Swanson • Clinical Problem: • Medication errors are the 2nd most frequent cause of injury among all types of medical errors. • The high frequency of medication errors results in patient harm and financial strain. • Medication error prevention is a world-wide priority. • The introduction of information technology offers new opportunities for reducing or preventing medical errors. • Bar Coding replaces manual documentation with electronic scanning of unique identifier codes that are transmitted to a database. • The aim of the project is to determine if the use of BCMA and EMAR’s reduce and prevent medication administration errors. • Clinical Question: • “What effect does the use of electronic scanners have on medication administration errors in hospitalized patients as compared to manual MAR methods? • Literature Review: • Using the UNG “Galileo Scholar” website, articles were gathered from large medical research databases such as CINAHL plus full text, Medline, and EbscoHost. The keywordsused during the research process included: “medication administration”, “bar-code scanning”, “technology”, and “error prevention”. Wildcard characters were used in the search process. The articles chosen were experimental studies conducted from 2007-2014. An ancestry approach was utilized on the descriptive studies to find randomized controlled trials (RCTs) related to the topic. • A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional or consumer (NCCMERP, 2006). • Implications for Nursing Practice • Nurses administer all medications, including IV piggy-back • medications and IV large-volume medications, through • BCMA. All information is documented with a time stamp • for improved accuracy of clinical information. • The specific goals of BCMA were to improve patient safety, improve the documentation of medication administration, decrease medication errors, and capture medication accountability data. • Bar-coded medication administration (BCMA) systems require that the nurse who administers the medication at the bedside should scan the patient’s identification bracelet and the unit dose of the medication being administered. • The system alerts the nurse to any mismatch of patient identity or of the name, dose, or route of administration of the medication. • BCMA reduces medication errors by ensuring the five ‘rights’ of medication administration: the right patient, drug dose, route, and time. • Suggestions for Further Research • In undertaking this difficult journey, attainment of “perfect safety” seems beyond the realm of human achievement. However, all who labor in this industry should strive to arrive at the destination called “no medication-related injury.” • Although the goal of BCMA is to enhance medication safety, studies that evaluate the prevention of potential harm after implementation of BCMA are limited. Future research should focus on the long-term effects of BCMA on medication error reduction, the causes of errors after BCMA implementation, the effects on nursing workflow and the harm prevented by this technology. • Synthesis of Literature • Problem/Background: Current evidence shows that errors in • the medication administration step pose to be the most • problematic of the entire medication process in hospital settings. • One observational study showed that less than 2% of medication • errors are intercepted and solved at the bedside (Helmons, P., • Wargel, L., & Daniels, C., 2009). Traditional medication • administration records (MAR) through the pen and paper route • have dominated the hospital setting for the past several decades, • but could be largely responsible for the majority of medication • errors. • One analysis study examined two sites where Site A implemented • the traditional MAR method and Site B implemented the BCMA • system. While the amount of medication errors at both sites • were roughly equal, Site Ashowed more serious medication • errors (omitted medicine or dose; wrong dose, strength or • frequency; and wrong documentation) than Site B (wrong • documentation and omission). • Two observational studies that implemented BCMA showed to • decrease turn-around time spent processing medication • doses in the pharmacy, as well as increase accuracy of patient • identification, inventory, medication administration, and staffing • of nurses and pharmacists (Skibinski, K., White, B., Lin, L., • Dong, Y., & Wu, W., 2007). • A pretest-posttest comparison of two hospitals on medication • administration accuracy rates showed that implementation of • BCMA into those two hospitals decreased medication errors as • is highlighted in the literature.