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Bar-Coded Medication System Has Shortcomings

Suboptimal implementation and design can increase medication errors, reduce patient safety

THURSDAY, July 3 (HealthDay News) -- Bar-coded medication systems, used to reduce administration-stage medication errors, are circumvented using various methods for over 10 percent of charted medications, according to study findings published in the July/August issue of the Journal of the American Medical Informatics Association.

Ross Koppel, Ph.D., of the University of Pennsylvania in Philadelphia, and colleagues conducted a study of bar-coded medication administration (BCMA) in five hospitals using various methods such as shadowing nurses using the bar-code system, interviewing staff, participating in staff meetings and analyzing bar-code system override log data.

The investigators found 15 different methods of working around the BCMA system, such as attaching patients' bar codes to computer equipment, scanners and nurses' belt-rings, and even to doorjambs. There were 31 different reasons cited for workarounds, such as unreadable bar codes, malfunctioning scanners, unreadable patient-ID wristbands, and emergencies. Nurses over-rode bar-code alerts for 10.3 percent of medications and for 4.3 percent of patients.

"These data show that as with all health care technologies, suboptimal design and implementation of BCMAs can facilitate new medication administration hazards, lead clinicians to deviate from required safe-use protocols, reduce the technology's safety benefits and enhance the probability of medication errors," the authors write. "Integrating BCMAs within real-world clinical workflows requires critical attention to use in situ to ensure safety features are used as intended."

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