Medication Safety and Technology

Medication safety has been a hot topic in healthcare quality and safety. According to the Food and Drug Administration, the incidence of medication errors has risen in the past decade (Food and Drug Administration, 2019). Therefore, various interventions have been used by hospitals and facilities to prevent these errors. Medication errors mainly arise from prescription, dispensation, administration, and monitoring.

Medication Safety and Technology

The contribution of technology in the prevention of medication errors has been enormous. One of the recent technologies that have been used to prevent errors due to dispensation and administration is the barcode medication administration (BCMA) technology.

I have witnessed and used BCMA in medication administration in my training and practice. However, medication errors still occurred. The purpose of this paper is to summarize my clinical health issue, seek evidence-based sources and synthesize these sources in the form of annotated bibliography.

Clinical Health Issue

Many items of literature have documented information on the efficacies and effectiveness of the use of BCMA in medication error prevention. Most sources support the benefits of BCMA in medication error prevention. However, the use of this technology has its flaws and drawbacks.

In this clinical issue, literature search and synthesis sought to answer a clinical question, ‘to what extent does the used barcode medication administration technology prevent medication errors when implemented successfully? From this question, further questions were derived. Does the use of BCMA need additional technology? What other factors affect the outcomes of the use of BCMA in medication safety?

Literature Search Process

Literature was searched in the ScienceDirect and PubMed libraries. These databases were selected because of the diversity in health technology resources and additional search features.  The literature search was enabled by the use of key terms: barcode medication administration, BCMA, medication errors, and medication safety.

Returned results were filtered only to show those articles published in the last five years. The manual selection of articles was based on the relevance to the research problem and research questions. A total of four articles were selected for this annotated bibliography.

Literature Synthesis

Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association: JAMIA, 27(5), 798–807. https://doi.org/10.1093/jamia/ocz231

This resource aimed at assessing the impact of various health information technologies used in medication error prevention on the costs and nurses’ documentation time. In this resource, the authors reviewed 33 articles that addressed their research question and met the inclusion criteria. I chose this article because it addressed BCMA in comparison with other technologies serving similar objectives in medication error prevention.

This study found that BCMA, as opposed to other technologies such as electronic health records, reduced nurses’ documentation time. However, other technologies also increased care efficiencies. The costs of care also reduced as nurses could shift attention to other value-adding activities to improve quality.

Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology used in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223

This article assessed policy deviations when using BCMA and the causes of these deviations during dispensing and administration of medications. The authors of this article conducted a prospective, mixed-methods study that observed medication administration in two inpatient wards. I chose this resource because it addresses the logistical aspects of the implementation of BCMA technology.

This study found that more than half the time, BCMA policy deviations occurred. Deviations included failure to scan the wristband, failure to scan medication, or laptop and power issues. This source concluded that BCMA implementation requires a working system that also requires nurses to adapt to safety needs and technology implementation goals. Designing the BCMA technology system should account for technical and human factors.

Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens, J. M. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings. Innovations, Quality & Outcomes2(4), 342–351. https://doi.org/10.1016/j.mayocpiqo.2018.09.001

This article assessed the outcomes of the implementation of a BCMA technology. The authors of this article recorded actual errors before the implementation of the BCMA technology and throughout the follow-up period. The authors also recorded the number of adverse events and data on adherence to BCMA technology. I included this resource because it addresses direct patient safety outcomes.

I also included this article because it is from a primary study that examined the implementation and direct outcomes of this implementation. This study found that the number of cases of actual patient harm reduced after the implementation of the technology. This study analyzed actual and not potential patient harm cases from medication errors. Consistency in the use of BCMA technology was associated with improved outcomes.

Williams, R., Aldakhil, R., Blandford, A., & Jani, Y. (2021). Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology? BMJ Open11(7), e044419. https://doi.org/10.1136/bmjopen-2020-044419

This article assessed the human factors that determined BCMA use and outcomes. This research study was a systematic review of 11 previous studies. I chose this article because it addressed not only the implementation factors but also the interdisciplinary issues that come with this technology. According to this article, systems design is a major usability factor that requires collaboration between the system users and designers. Adaptation of users to the system requires overcoming usability barriers.

Summary

Developing this annotated bibliography has taught me to assemble and appraise useful evidence in answering research questions. Determining the credibility of the sources was my key take-home message and aha moment. I CRAAP test to ensure that my sources were current, relevant, authoritative, accurate, and purposeful.

I have learned to judge sources based on the methodology to assess their evidence level, thus prioritizing high-level evidence and quality sources. Credible sources enabled me to draw reliable and valid evidence in the view of evidence-based practice.

From this research, I have learned three key points: BCMA is not a stand-alone technology; usability is as important as patient safety and care quality, and consistency in the use of technology is key to a successful safety and quality outcomes.

These learning points suggest the need for interdisciplinary engagement for safety outcomes and also the need for staff sensitization in the use of BCMA technology. When staff members understand how to use the technology, policy deviations and adherence issues are minimized.

References

  • Food and Drug Administration. (2019, August 23). Working to reduce medication errors. U.S. Food and Drug Administration; FDA. https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errors
  • Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association: JAMIA27(5), 798–807. https://doi.org/10.1093/jamia/ocz231
  • Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology used in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223
  • Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens, J. M. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings. Innovations, Quality & Outcomes2(4), 342–351. https://doi.org/10.1016/j.mayocpiqo.2018.09.001
  • Williams, R., Aldakhil, R., Blandford, A., & Jani, Y. (2021). Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology? BMJ Open11(7), e044419. https://doi.org/10.1136/bmjopen-2020-044419

Assessment 2: Applying Research Skills

Create a 2-4 page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you.

Introduction

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research, which will be a current health care problem or issue faced by a health care organization that is of interest to you.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

View the Assessment Topic Areas media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

Summarize the health care problem or issue.

Describe your interest in the topic.

Describe any professional experience you have with this topic.

Identify peer-reviewed articles relevant to health care issue or problem.

Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.

Refer to the NHS-FPX4000: Developing a Health Care Perspective Library Guide to help you locate appropriate references.

Use keywords related to the health care problem or issue you are researching to select relevant articles.

Assess the credibility and explain relevance of the information sources you find.

Determine if the source is from an academic peer-reviewed journal.

Determine if the publication is current.

Determine if information in the academic peer-reviewed journal article is still relevant.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:

Identify the purpose of the article.

Summarize the information.

Provide rationale for inclusion of each article.

Include the conclusions and findings of the article.

Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.

List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.

Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.

Summarize what you have learned from developing an annotated bibliography.

Summarize what you learned from your research in a separate paragraph or two at the end of the paper.

List the main points you learned from your research.

Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 2 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

Length: 2–4 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.

Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Content: Provide a title page and reference page following APA style.

References: Use at least four scholarly or academic peer-reviewed journal articles.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

Assess the credibility and relevance of information sources.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format.

Summarize what was learned from developing an annotated bibliography.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Apply academic peer reviewed journal articles relevant to the health care problem or issue being researched.

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Integrate into text appropriate use of scholarly sources, evidence, and citation style.