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Presented by: Barbara Seebold RN. Objectives Describe the Barcode System Describe the benefits of...
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Transcript of Presented by: Barbara Seebold RN. Objectives Describe the Barcode System Describe the benefits of...
“Implementing A Bar-Coded Bedside Medication
Administration System”
Presented by:Barbara Seebold RN
ObjectivesDescribe the Barcode SystemDescribe the benefits of barcode medication administration
systemDescribe the hardware and software in the barcode systemEvaluate the Usability of the Software
(Mitch Work,2005)
ObjectivesSummarize The CriteriaReview of Information SystemRecite a RecommendationSummarize the advantages and disadvantages of
barcode medication administration system Summarize the legal and ethical issues of barcode
medication administration systemDescribe the Nurse Informaticist
Competencies, Functions and Responsibilities
(St. Luke’s 2008, Cummings and Ratko, 2005, LaDuke 2009)
System DescriptionBarcodes provide valuable verification of
medication administration , assuring "five rights" are confirmed
Barcode technology at bedside shows impressive gains in reducing medication administration errors
(Mitch Work,2005, Sakowski, 2006)
Utilized HardwareLaptops in patient rooms instead of computers on
carts
Wireless bar code readers
Bar-code point-of-care
Automated drug-dispensing systems and Robotics
(St. Luke’s 2008)
Laptops Priority for hardware ease-of-use Acceptable to all parties Soliciting feedback and including pharmacy and
clinical personnel Getting nursing input was essential in device
selection
(St. Luke’s,
2008)
Utilized SoftwareImplementation of e-MAR in inpatient areas Computerized physician order entry
(St. Luke’s, 2008)
eMarCaregiver establishes Bluetooth connection
between bar code reader and laptopCaregiver logs in by scanning identification badge
and entering PINCaregiver identifies patient by scanning the patient
identification wristbandCaregiver scans dosed medication with either
manufacture or hospital generated barcodeSoftware ready at bedside with patient-specific
information viewable to caregiver during medication administration
(St. Luke’s, 2008)
eMarCaregiver watches on-screen for warnings of
'Five Rights' violations
- Right Patient - Right Medication - Right Dose - Right Time - Right Method of Administration
(St. Luke’s 2008)
eMar
Caregiver reviews warnings, and determines next step Caregiver exercises clinical decision-making
responsibilities and documents decisions/actionsAll data captured/actions taken are stored in patient's
medication administration record
(St. Luke’s, 2008)
Usability of eMarAdequate design characteristicsFocus group used to begin process of useUnderstandable and easy to learn interfaceProblems with system detected early and worked
outEnd users evaluation passed for final use
(McGonigle, 2009)
Review Of Information SystemClinical information systemPhysicians, Nurses and many others use this
application to monitor patient careAllows for the function of scanning and
documentationConfiguration used is the Workstation Health level 7 is the data standard Clinical Care classification scheme
(McGonigle, 2009)
Recommendation
YES, I recommend this system to others implementing this trend because I have used it so I have experienced it and already know how it works and have no trouble with it. It is very easy once you get to know it. It may not seem that way once you start, but after you learn it, it is very, very easy.
Advantages
Reduction of medication administration errors
Increased patient safety and accurate reporting
Improved communication between departments
Improved process integration and information sharing
Reduction in overall cost of care
Valuable management-level decision-making tools (St. Luke’s 2008)
AdvantagesDecrease errors: right medication, right route, right patient, right amount, right time
Increased efficiency at bedside
Minimally increasing nurse staffing time requirements
Improve nursing staff job satisfaction
Improve patient satisfaction
Generate positive public relations with the local community (Mitch Work,2005)
(
DisadvantagesBarcode scanning can interrupt nurse workflow processes, leading to frustration/fatigue among staff.Barcode equipment must be reliable, readily available, and user-friendly to be used effectively.Select barcode technologies may lack certain desirable features/functions, which limit their usefulness.Barcode system approaches to complex IV solutions, non-typical formulations, and other pharmacy compounded products are still in the development phase.Interfacing between various hospital computer systems can be problematic.
(Cummings and Ratko, 2005)
Legal/Ethical Issues Scanning is a form of documentation
Scan bar-code on the patient's ID wristband
Scan medication bar code after removing the medication
Investigation could constitute professional misconduct
Criminal charges
Nurses can and have lost their jobs (LaDuke
2009)
Nurse Informaticist Competencies, Functions and Responsibilities
Establishes connection between bar code reader and laptop Logs in by scanning identification badge and entering PIN Identifies patient by scanning the patient identification wristband Scans dosed medication with either manufacture or hospital generated barcode Watches on-screen for warnings of 'Five Rights' violationsReviews warnings, determines next step, exercises decision-making responsibilities, documents decisions/actions
(St. Luke’s
2008)
Summary
Having BPOC in place is the ultimate objectiveAddressing Pre-BPOC situations is a purposeful
and well thought out methodThis can be a welcomed precursor that aids in
determining the needs of the institution about BPOC
ReferencesMcGonigle, D. and Mastrian, K. (2009), Nursing Informatics and the
Foundation of Knowledge, Jones and Bartlett Publishers,
Sudbury, Massachusetts, Retrieved March 1, 2010Sakowski , J. (2006), Using a Bar-Coded Medication Administration
System to Prevent Medication Errors, American Journal of
Health-System Pharmacy, Retrieved January 31, 2010 from
http://www.medscape.com/viewarticle/519719St. Luke’s Hospital,(2008) Implementing a Bar Coded Medication Administration System. Retrieved January 31, 2010 from http://codecorp.com/stlukes.html
ReferencesCummings, J. and Rayko, T. (2005) Bar-coding to Enhance Patient Safety,
Patient Safety and Quality HealthCare, Retrieved February 1, 2010 from http://www.psqh.com/sepoct05/barcodingrfid1.html
LaDuke, S. (2009) Playing it safe with bar code medication administration. Nursing 2010. Retrieved February 6, 2010 from http://journals.lww.com/nursing/Fulltext/2009/0500/Playing_ it_safe_with_bar_code_medication.17.aspx
Work, M/ (2005)Improving Medication Safety with a Wireless, Mobile Barcode System in a Community Hospital, Patient Safety and Quality HealthCare, Retrieved February 1, 2010 from http://www.psqh.com/mayjun05/casestudy.html