Electronic Medication Administration With Barcoding

Electronic Medication Administration with Barcoding

Medication errors are some of the commonest sources of patient safety risks in the United States currently. Annually, the food and drug administration records more than 100,000 cases of suspected medication errors or those related to medication errors in the US (U.S. Food and Drug Administration, 2019). These rates have exponentially been increasing over the past years and have partly been associated with improved reporting systems and awareness. However, there is still a need to improve the prevention of medication errors.

Technology has played an essential role and still has room to improve this prevention. The use of barcode technology was borrowed from other sectors to improve healthcare prevention. I selected this Barcode Medication Administration (BCMA) because it is novel in most health organizations, including primary care settings that I have seen and it can be used at the bedside to verify the five ‘rights’ of medication administration, and nursing station, pharmacy and other points of medication administration.

I also selected this technology because it directly affects nursing practice and requires direct nursing input in daily clinical activities. The purpose of this paper is to present an annotated bibliography of scholarly literature sources informing about the use of barcode technology to improve medication error prevention.

Literature Search

The literature acquisition process involved the identification of database sources, search key terms, and search strategies. This search was conducted in the Cochrane Library, BioMed Central (BMC), and PubMed databases for articles. Key search terms were bar code, barcode, medication administration, BCMA, medication errors, and bar code. These key terms were joined by ‘AND’ and ‘OR’ as the key Boolean operators as appropriate and meaningful to narrow the search in the three databases.

To filter the search results further, the article results were narrowed down using article methodology, language, age, and availability as full-texts. Therefore, the search limited the final count of articles to those published in the past five years, in the English language, and available as full texts, not just abstracts. Review reviews, meta-analyses, randomized controlled trials, and other experimental studies were prioritized. Thereafter, six articles were manually handpicked based on their currency and relevance to the topic under study.

Literature Synthesis

Barakat, S., & Franklin, B. D. (2020). An evaluation of the impact of barcode patient and medication scanning on nursing workflow at a UK teaching hospital. Pharmacy (Basel, Switzerland), 8(3), 148. https://doi.org/10.3390/pharmacy8030148

This article was a comparative study that focused on the outcomes of barcode medication administration (BCMA) implementation in an intervention ward and control ward. The outcomes were the duration of rounds, the duration of medication administration, and general workflow. The author of this source reported that BCMA doesn’t affect round duration despite increasing the duration of medication administration.

I chose this source because the use of a control group makes the findings of this study reliable. However, this article does not focus on the patient safety aspect of education administration. Its relevance to nursing practice is work efficiency and workflow.

Owens, K., Palmore, M., Penoyer, D., & Viers, P. (2020). The effect of implementing bar-code medication administration in an emergency department on medication administration errors and nursing satisfaction. Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association, 46(6), 884–891. https://doi.org/10.1016/j.jen.2020.07.004

The authors of this source focused on pertinent outcomes before and after the implementation of BCMA technology in the ED but with no use of a control population. I chose this article because it directly addressed the reduction in medication errors as the primary outcome. The authors found that BCMA reduced medication errors by 74.4% after implementation. The sample size was relatively reasonable (676) but the lack of a control group leaves room for confounders.

Nevertheless, this source provides an actual practice implementation framework for BMCA in nursing and healthcare. It documents a model that any nursing care setting can adopt to set up, implement, and evaluate BCMA technology to improve patient care quality and nurse satisfaction.

Sloss, E. A., & Jones, T. L. (2019). Alert types and frequencies during bar code-assisted medication administration: A systematic review. Journal of Nursing Care Quality, 35(3). https://doi.org/10.1097/NCQ.0000000000000446

The authors of this resource focused on the types of alerts that BCMA technology generates. In this resource, the authors synthesized research findings from primary sources. I chose this source because it is a systematic review and thus, high-level evidence. This resource found that BCMA had an alert generation frequency of about up to 42% of the time. Patient mismatch alerts and wrong disease are the commonest alerts.

Sometimes, alerts from this technology are not clinically meaningful. This finding is important to nursing because it reinforces that this technology is not 100% sensitive and specific in medication error prevention; thus need for complementary strategies.

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 & Outcomes, 2(4), 342–351. https://doi.org/10.1016/j.mayocpiqo.2018.09.001

I chose this source because it answers my research problem in its entirety. The article addresses patient harm as a result of medication errors and how the implementation of BMCA influenced this outcome. This article reported a 43.5% reduction in actual medication errors. This source emphasized the consistency in the use of BCMA to improve patient outcomes.

This is important to nursing practice and interdisciplinary teams because no technology is currently foolproof in medication error prevention and other sources of medication error such as prescription and monitoring can still cause patient harm.

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 Open, 11(7), e044419. https://doi.org/10.1136/bmjopen-2020-044419

I chose this systematic review because it addressed usability, enabler, and barrier factors in the implementation and evaluation of BCMA. The authors of the article reviewed primary sources for mediating factors in the successful use of BCMA. This study recommended a collaborative approach between designing and utilization of BCMA. This is important in nursing because the efficiency of care will depend on the nurses’ ability to navigate and use BCMA technologies successfully.

A usable system will also promote patent safety because errors due to ineffective design will be minimized. This source emphasized the interdisciplinary approach in system design and implementation and use, thus appropriate to current nursing paradigms and care approaches. However, gaps still remain in the technologies’ consistency of use among nurses.

Zheng, W. Y., Lichtner, V., Van Dort, B. A., & Baysari, M. T. (2021). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research in Social & Administrative Pharmacy: RSAP, 17(5), 832–841. https://doi.org/10.1016/j.sapharm.2020.08.001

This systematic review did not only focus on BCMA but also on Automated Dispensing Cabinets (ADCs) and closed-loop Electronic Medication Management Systems (EMMS). I chose this article because it not only focused on medication safety but also the work process and drug diversion in a non-primary care setting. The authors of this source reviewed 16 primary articles that met their inclusion criteria.

This source found that BCMA implementation reduces medication error rates. However, BCMA technology can also contribute to medication errors through wrong barcoding and unreadable barcodes. Thus, this resource emphasized the need for complementary technologies to supplement BCMA even in closed and well-monitored systems.

Conclusion

Generally, BCMA technology is being widely adopted in various primary and referral care settings to improve patient care. The key outcome is a reduction in potential and actual medication errors that lead to or have the potential to cause patient harm. Like any other healthcare technology, BCMA technology requires systematic sourcing, implementation, and evaluation.

Human and technological factors such as usability, efficiency, and timeliness are key. Preexisting resources such as electronic health records and computerized physician order entries (CPOEs) are complementary to successful BCMA technology implementation. When successfully implemented, this technology can improve patient care safety, nurse satisfaction, patient satisfaction, and care efficiency. Therefore, this technology remains essential in the campaigns to promote patient safety.

References

U.S. 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

Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing Instructions

Write a 4-6 page annotated bibliography where you identify peer-reviewed publications that promote the use of a selected technology to enhance quality and safety standards in nursing.

Introduction
Before you begin to develop the assessment you are encouraged to complete the Annotated Bibliography Formative Assessment. Completing this activity will help you succeed with the assessment and counts towards course engagement.

Rapid changes in information technology go hand-in-hand with progress in quality health care delivery, nursing practice, and interdisciplinary team collaboration. The following are only a few examples of how the health care field uses technology to provide care to patients across multiple settings:

Patient monitoring devices.
Robotics.
Electronic medical records.
Data management resources.
Ready access to current science.
Technology is essential to the advancement of the nursing profession, maintaining quality care outcomes, patient safety, and research.

This assessment will give you the opportunity to deepen your knowledge of how technology can enhance quality and safety standards in nursing. You will prepare an annotated bibliography on technology in nursing. A well-prepared annotated bibliography is a comprehensive commentary on the content of scholarly publications and other sources of evidence about a selected nursing-related technology. A bibliography of this type provides a vehicle for workplace discussion to address gaps in nursing practice and to improve patient care outcomes. As nurses become more accountable in their practice, they are being called upon to expand their role of caregiver and advocate to include fostering research and scholarship to advance nursing practice. An annotated bibliography stimulates innovative thinking to find solutions and approaches to effectively and efficiently address these issues.

Preparation
To successfully complete this assessment, perform the following preparatory activities:

Select a single direct or indirect patient care technology that is relevant to your current practice or of interest to you. Direct patient care technologies require an interaction, or direct contact, between the nurse and patient. Nurses use direct patient care technologies every day when delivering care to patients. Electronic thermometers or pulse oximeters are examples of direct patient care technologies. Indirect patient care technologies, on the other hand, are those employed on behalf of the patient. They do not require interaction, or direct contact, between the nurse and patient. A handheld device for patient documentation is an example of an indirect patient care technology. Examples of topics to consider for your annotated bibliography include:
Delivery robots.
Electronic medication administration with barcoding.
Electronic clinical documentation with clinical decision support.
Patient sensor devices/wireless communication solutions.
Real-time location systems.
Telehealth.
Workflow management systems.
Conduct a library search using the various electronic databases available through the Capella University Library.
Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources.
Access the NHS Learner Success Lab, linked in the courseroom navigation menu, for additional resources.
Scan the search results related to your chosen technology.
Select four peer-reviewed publications focused on your selected topic that are the most interesting to you.
Evaluate the impact of patient care technologies on desired outcomes.
Analyze current evidence on the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team.
Integrate current evidence about the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team into a recommendation.
Notes
Publications may be research studies or review articles from a professional source. Newspapers, magazines, and blogs are not considered professional sources.
Your selections need to be currentâ€”within the last five years.
Annotated Bibliography
Prepare a 4â€“6 page annotated bibliography in which you identify and describe at least four peer-reviewed publications that promote the use of your selected technology to enhance quality and safety standards in nursing. Be sure that your annotated bibliography includes all of the following elements:

Introduction to the Selected Technology Topic
What is your rationale for selecting this particular technology topic? Why are you interested in this?
What research process did you employ?
Which databases did you use?
Which search terms did you use?
Note: In this section of your bibliography, you may use first-person since you are asked to describe your rationale for selecting the topic and the research strategies you employed. Use third person in the rest of the bibliography, however.
Annotation Elements
For each resource, include the full reference followed by the annotation.
Explain the focus of the research or review article you chose.
Provide a summary overview of the publication.
According to this source, what is the impact of this technology on patient safety and quality of care?
According to this source, what is the relevance of this technology to nursing practice and the work of the interdisciplinary health care team?
Why did you select this publication to write about out of the many possible options? In other words, make the case as to why this resource is important for health care practitioners to read.
Summary of Recommendation
How would you tie together the key learnings from each of the four publications you examined?
What organizational factors influence the selection of a technology in a health care setting? Consider such factors as organizational policies, resources, culture/social norms, commitment, training programs, and/or employee empowerment.
How would you justify the implementation and use of the technology in a health care setting? This is the section where you will justify (prove) that the implementation of the
patient care technology is appropriate or not. The evidence should be cited from the literature that was noted in the annotated bibliography.
Consider the impact of the technology on the health care organization, patientcare/satisfaction, and interdisciplinary team productivity, satisfaction, and retention.
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 3 Example [PDF].
Additional Requirements
Written communication: Ensure written communication is free of errors that detract from the overall message.
Length: 4â€“6-typed, double-spaced pages.
Number of resources: Cite a minimum of four peer-reviewed publications, not websites.
Font and font size: Use Times New Roman, 12 point.
APA: Follow APA style and formatting guidelines for all bibliographic entries. Refer to Evidence and APA as needed.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
Analyze current evidence on the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team.
Integrate current evidence about the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team into a recommendation.
Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.
Describe organizational factors influencing the selection of a technology in the health care setting.
Justify the implementation and use of a selected technology in a health care setting.
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Create a clear, well-organized, and professional annotated bibliography that is generally free from errors in grammar, punctuation, and spelling.
Follow APA style and formatting guidelines for all bibliographic entries.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.