Barcode Technology

BarcodeTechnology

Abarcode Medication Administration is an electronic scanning devicewhich intercepts or rather interrupts erroneous medication at theadministration juncture. During administration of medicine using thedevice, a medical practitioner scans the patient through a barcode onthe wristband of the patient. The medicine also has a barcode whichis also scanned to verify whether the matches the patient’s code.Scanning the medicine ascertains whether the medicine is correct,dosage is right, time is accurate and is administered in the correctroute. The system is used in combination with an electronicmedication administration record system (eMAR). The eMAR is thecommunication interface. It automatically stores medicationadministration within the Electronic Health Record (EHR) system.Integrating eMAR and BCMA enables capturing of data with better timeaccuracy than manual procedures would have accomplished. The systemis therefore meant to limit errors pertaining medication within thehealth care system. It is meant to improve on safety and quality ofadministering medication. The system’s main aims are to createonline records, improve accuracy and prevent errors whenadministering medication. In that regard, this paper will look tooutline views from different research works on the same. It willanalyze the research method used, sampling method, measurement andfindings among others of various studies. The studies were chosen inaccordance to the EBSCO host database which offers a wide range ofbibliographic and full text database for the purpose of research [ CITATION Mar121 l 1033 ].

HeatherH. Seibert (2014), conducted a study labeled “Effect of barcodesystem with eMAR on accuracy rates in medication.” The purpose ofthis study was to evaluate the impact of barcode enabled systems witheMAR on administration of medicine errors. The study utilized apretest-posttest nonequivalent evaluation method to assess theaccuracy rates at two different hospitals. The patient care involved3 matched parts within the two hospitals, two telemetry, medicalsurgical ICU, emergency unit, two rehabilitation center and twomedical surgical. It also took into consideration inpatient andoutpatient oncology. The above units were considered at two differenthospitals designated hospital 1 and hospital 2. The two hospitals hada total of 644 beds and the yearly patient were 22,807. The staffinclude 455 community based physicians, 53 pharmacists and 1245nurses.

Theaccuracy rates for the administration of medical were then observedand documented considering before implementation of the system andafter. In that respect, the data was recorded in the 1stphase before implementation of system. Data was analyzed about 6 to12 months after the 2ndand 3rdphases respectively after implementation of the BCMA-eMAR system.

Methods

Datacollection was done in a pretest-posttest comparing of groups.Observation of medication errors were done before implementation ofthe system and after and appropriate data recorded. Directobservation was the data collection criteria utilized. The researchpopulation were done randomly i.e. including observing nurses whileadministering medication at the selected times. The study alsotargeted a variety of individuals across the ages i.e. diversifiedadult population.

Barker’sdirect observation was utilized to collect and measure data. Themechanism is valid and is common when comparing data or ratherchecking on errors. It is non-punitive and non-judgmental. Errorswere also recorded and tabulated using the AU MEDS mechanism. It is arecognized standard across the nation used to monitor errors relatedto medication and is centered on direct observation. 15 licensedhealth care practitioners were involved in collection of data. Allthe units where the study was conducted had observers who witnessedthe events as they happened. In case the observer realized an errorthat could be detrimental to the patient, he/she would interveneimmediately [ CITATION Hea14 l 1033 ].

Results/findings

Inhospital 1, the general rate of accuracy considerably increased fromthe 1stphase i.e. 89% to 90% in the 3rdphase. However, excluding wrong time errors, rate of accuracy rosefrom 92% during the 1stphase to 96% in the 3rdphase. There was no considerable variance in the general rate ofaccuracy from 1stphase to 3rdphase at hospital 2. Excluding wrong time errors, the accuracy ratiorose from 93 percent in the 1stphase to 96 percent in the 3rdphase.

Thestudy conclusively affirmed that implementation of the system led toan increase in the rates of accuracy. The study also affirmed that nofresh errors related to the system were introduced.

AlexanderA. Leung’s (2015) study “Safe practice of Barcode technology”,established that errors were considerably reduced with theintroduction of this system. The purpose of this research were toadvocate for barcode verification since they improved the health caresystem.

Methods

Theresearch relied on narrative reviews centered on scientificpeer-reviewed publications and gray literature. Additionally,knowledge as well as experience obtained from experts within thefield were utilized. The preliminary stage involved reviewingabstracts and titles of any articles having measured results onbarcode technology. The secondary screening entailed a full textreview of the articles. Any secondary research works as well asstudies that had no records on safety measures were excluded. Withthe broad search, 495 citations were realized. 75 of them wereconsidered for full text review. 28 research works were then utilizedwhereby 11 of them recorded medication errors. The research workswere then categorized in accordance to the kind of result recorded,overall findings and study design. Content-area experts were thenutilized in integrating the findings and formulating the necessarystandards [ CITATION Ale15 l 1033 ].

Results

Inaccordance to the study, transcript errors were considerablyeliminated. Steps involved in entry used to be manual i.e. physicianorder, medication lists by clerks and drug administration by nurses.Medication administering were manually maintained and updated by thenurses. However, after integration of this system, the errors reducedconsiderably. For instance, transcription errors could not bedetected after integration of the system at 2 surgical centers inOhio State University. Dispensing errors were also reducedsubstantially. As Poon et al affirmed, barcode implementation led tosignificant reduction in dispensing errors. As emphasized by mostresearch works, administration of medication errors reduced by 40 to80 percent reduction in rates of errors. As per Poon et al realized,timing errors reduced by 27.3 percent and non-timing by 41.4 percent.Generally, as per the findings, the technology is viable with atremendous improvement in drug administration.

KayleghMarx (2013), performed a research to ascertain the impacts of barcodein the health care system. They ascertained that barcodes are quitehelpful in minimizing errors related to medication administration.The study purposed to outline the impacts of barcodes inadministering medicine.

Methods

Thestudy was conducted on an observational manner. Observation was doneon a surgical ward before and after introduction of the BCMA system.It was done on 28 beds within a 555 bed community sanatorium inHolland. Physicians used an electronic means to record patient datawhereas nurses manually recorded the data. Data was collected 1 weekbefore implementation of the system and then six months afterimplementation. Nurses were observed in the process. Apart fromself-administration of insulin and drugs, all other mechanisms weremonitored. Errors were classified as omissions i.e. medication notadministered but is prescribed, unauthorized medicine administration,too late or early administration, wrong administration of a patient,wrong dose and logistic omission [ CITATION Kay13 l 1033 ].

Results/findings

68drug administration errors were detected out of 945 administratorsi.e. rate of 7.2% prior to the implementation of the BCMA. Only 36errors were detected out of 1001 i.e. 3.6% after realization of thesystem. Number of errors as per categories before and afterimplementation of the system are as below

Number of errors before barcode implementation

Number of errors after barcode implementation

Number

Percentage (%)

Number

Percentage (%)

Omissions

2

0.2

1

0.1

Logistic omission

12

1.3

2

0.2

Unauthorized administration of the drug

0

0

0

0

Wrong form dosage

0

0

0

0

Administering too early

36

3.8

30

3

Administering too late

4

0.4

2

0.2

Wrong dose

12

1.3

1

0.1

Extra dose

2

0.2

0

0

Wrong patient

0

0

0

0

Conclusion

Utilizationof the barcode technology generally leads to limitation of errorswithin the health care facilities. As per the research studies, therewas considerable reduction in errors during administration of drugs.

References

Alexander A. Leung, C. R. (2015). A Safe Practice Standard for Barcode Technology. A Safe Practice Standard for , 89-99.

Heather H. Seibert, R. R. (2014). Effect of barcode technology with electronic medication administration record on medication accuracy rates. Effect of barcode technology with electronic medication administration record on medication accuracy rates, 209-220.

Kayleigh Marx, L. L. (2013). Effect of bar-code-assisted medication administration on medication administration errors. Effect of bar-code-assisted medication administration on medication administration errors, 572-575.

Mary V. Wideman, M. E. (2012). Barcode Medication Administration: Lessons Learned from an Intensive Care Unit Implementation . Barcode Medication Administration: Lessons Learned from an Intensive Care Unit Implementation , 437-453.

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