OBJECTIVE: Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit. STUDY DESIGN: We conducted a prospective, observational, cohort study of a BCMA system intervention in a neonatal intensive care unit. Participants were admitted neonates during 50 weeks. Medication errors and potential or preventable ADEs were detected by a daily structured audit of each subject's medical record, with assignment of an event as a preventable ADE made by blinded assessors. The generalized estimating equation method was used in modeling the targeted, preventable ADE rate with covariates. RESULTS: A total of 92,398 medication doses were administered to 958 subjects. The generalized estimating equation method yielded a relative risk of preventable ADE when the system was implemented of 0.53 (95% confidence limits 0.29 to 0.91, P = .04), adjusted for log(10)doses of medication/subject/day, a significant predictive covariate (P < .001), as well as for birth weight, sex, Caucasian race, birth cohort number, and nursing hours/subject/day. CONCLUSION: The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day, an important risk exposure.
OBJECTIVE:Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit. STUDY DESIGN: We conducted a prospective, observational, cohort study of a BCMA system intervention in a neonatal intensive care unit. Participants were admitted neonates during 50 weeks. Medication errors and potential or preventable ADEs were detected by a daily structured audit of each subject's medical record, with assignment of an event as a preventable ADE made by blinded assessors. The generalized estimating equation method was used in modeling the targeted, preventable ADE rate with covariates. RESULTS: A total of 92,398 medication doses were administered to 958 subjects. The generalized estimating equation method yielded a relative risk of preventable ADE when the system was implemented of 0.53 (95% confidence limits 0.29 to 0.91, P = .04), adjusted for log(10)doses of medication/subject/day, a significant predictive covariate (P < .001), as well as for birth weight, sex, Caucasian race, birth cohort number, and nursing hours/subject/day. CONCLUSION: The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day, an important risk exposure.
Authors: Hanna M Seidling; Anette Lampert; Kristina Lohmann; Julia T Schiele; Alexander J F Send; Diana Witticke; Walter E Haefeli Journal: Br J Clin Pharmacol Date: 2013-09 Impact factor: 4.335
Authors: Carmen Guadalupe Rodriguez-Gonzalez; Ana Herranz-Alonso; Maria Luisa Martin-Barbero; Esther Duran-Garcia; Maria Isabel Durango-Limarquez; Paloma Hernández-Sampelayo; Maria Sanjurjo-Saez Journal: J Am Med Inform Assoc Date: 2011-09-02 Impact factor: 4.497
Authors: Peter J Gates; Melissa T Baysari; Madlen Gazarian; Magdalena Z Raban; Sophie Meyerson; Johanna I Westbrook Journal: Drug Saf Date: 2019-11 Impact factor: 5.606
Authors: Laura E Miller; Chris DeRienzo; P Brian Smith; Carl Bose; Reese H Clark; C Michael Cotten; Daniel K Benjamin; Chi D Hornik; Rachel G Greenberg Journal: J Perinatol Date: 2020-10-08 Impact factor: 2.521