Barcode-Assisted Medication Administration (BCMA) is Working, So Why Aren’t More Hospitals Using It?

by pharmacy on May 28, 2014

pharmacy-barcode-medication-administrationIt’s estimated that medication errors occur unacceptably frequently, about 1 error per day for each hospitalized patient, which adds up to nearly half a million adverse drug issues resulting in patient harm every year. BCMA is intended to reduce or eliminate those errors and a new study shows it’s working…just not as well as expected.

To determine the effectiveness of the BCMA and electronic medication administration records (eMARs), researchers at St. Joseph’s/Candler Health System in Savannah, Georgia assessed the drug administration records before BCMA and then 6 and 12 months after the new technology rolled out.

The system includes two hospitals, with a total of 23,000 patients per year and 455 physicians, 53 pharmacists, and 1245 nurses providing care.

The researchers found that after a year, overall medical accuracy increased by 1% – from 89% accuracy to 90% accuracy – in the first hospital they assessed. When they excluded wrong-time errors, the accuracy increased from 92% to 96%.

In the second hospital, improved from 93% to 96% when wrong-time errors were excluded from the data, but there was no change with wrong-time errors included in the data set.

It’s significant to note that the new BCMA system did not introduce new errors into the medication delivery process, and nurses adjusted well when they found that scanning was fast and easy with wireless bedside scanners.

Perhaps the reason less than half of all community hospitals have implemented BCMA is the limited clinical data available. Is the cost of implementation and training worth the limited benefit already proven? Will technology prove superior and less time consuming than direct observation and voluntary reporting?

The study author, manager and clinical pharmacy specialist at St. Joseph’s/Candler Dr. Heather Seibert, said pharmacists can actively influence outcomes by programming barcodes to provide more useful information to the administering nurses.

For example, a pharmacist might set an alert to stop nurses from administering a scheduled medication if blood pressure readings are not within set parameters. Armed with such warnings, nurses could avoid all-too-common medication error events from compromising patient health.

Pharmacist participation on this level can really take the pressure off busy nurses, who can’t be expected to remember every detail. The information that can be encoded in barcodes can greatly improve patient outcomes caused by medication administration errors.

More studies are needed, and the accuracy of voluntary reporting that provide the baseline numbers should be considered. As hospitals see improvement and hear from nurses using the system, hopefully they will be more willing to adopt the new technology. Is it possible to eliminate adverse drug events and prevent half a million errors per year? That’s the intent of the program…but only time will tell.

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