Heather H Seibert1, Ray R Maddox, Elizabeth A Flynn, Carolyn K Williams. 1. Heather H. Seibert, Pharm.D., M.B.A., is Manager and Clinical Pharmacy Specialist, Centers for Medication Management; and Ray R. Maddox, Pharm. D., FASHP, is Director, Clinical Pharmacy, Research and Pulmonary Medicine, St. Joseph's/Candler Health System, Savannah, GA. Elizabeth A. Flynn, Ph.D., is Independent Research Consultant, Artesia, NM. Carolyn Williams, B.S.Pharm., is Medication Safety Specialist, Clinical Pharmacy, St. Joseph's/ Candler Health System.
Abstract
PURPOSE: The effect of barcode-assisted medication administration (BCMA) with electronic medication administration record (eMAR) technology on the occurrence of medication administration errors was evaluated. METHODS: A pretest-posttest nonequivalent comparison group was used to investigate the effect of BCMA-eMAR on the medication administration accuracy rates at two community-based hospitals. Patient care units included three matched pairs in the two hospitals-two medical-surgical, two telemetry, and two rehabilitation units-plus a medical-surgical intensive care unit, an emergency department, and both an inpatient oncology unit and an outpatient oncology service at one of the hospitals. Medication administration accuracy rates were observed and recorded before (phase 1) and approximately 6 and 12 months after (phases 2 and 3, respectively) the implementation of BCMA-eMAR. RESULTS: The overall accuracy rate at hospital 1 increased significantly from phase 1 (89%) to phase 3 (90%) (p = 0.0015); if wrong-time errors are excluded, the accuracy rate improved from 92% in phase 1 to 96% in phase 3 (p = 0.000008). The overall accuracy rate did not change significantly from phase 1 to phase 3 at hospital 2; when wrong-time errors were excluded from consideration, the accuracy rate improved from 93% in phase 1 to 96% in phase 3 (p = 0.015). CONCLUSION: Implementation of BCMA-eMAR in two hospitals was associated with significant increases in total medication accuracy rates in most study units and did not introduce new types of error into the medication administration process. Accuracy rates further improved when wrong-time errors were excluded from analysis. The frequency of errors preventable by BCMA-eMAR decreased significantly in both hospitals after implementation of that technology. BCMA-eMAR and direct observation were more effective than voluntary reporting programs at intercepting and recording errors and preventing them from reaching patients.
PURPOSE: The effect of barcode-assisted medication administration (BCMA) with electronic medication administration record (eMAR) technology on the occurrence of medication administration errors was evaluated. METHODS: A pretest-posttest nonequivalent comparison group was used to investigate the effect of BCMA-eMAR on the medication administration accuracy rates at two community-based hospitals. Patient care units included three matched pairs in the two hospitals-two medical-surgical, two telemetry, and two rehabilitation units-plus a medical-surgical intensive care unit, an emergency department, and both an inpatient oncology unit and an outpatient oncology service at one of the hospitals. Medication administration accuracy rates were observed and recorded before (phase 1) and approximately 6 and 12 months after (phases 2 and 3, respectively) the implementation of BCMA-eMAR. RESULTS: The overall accuracy rate at hospital 1 increased significantly from phase 1 (89%) to phase 3 (90%) (p = 0.0015); if wrong-time errors are excluded, the accuracy rate improved from 92% in phase 1 to 96% in phase 3 (p = 0.000008). The overall accuracy rate did not change significantly from phase 1 to phase 3 at hospital 2; when wrong-time errors were excluded from consideration, the accuracy rate improved from 93% in phase 1 to 96% in phase 3 (p = 0.015). CONCLUSION: Implementation of BCMA-eMAR in two hospitals was associated with significant increases in total medication accuracy rates in most study units and did not introduce new types of error into the medication administration process. Accuracy rates further improved when wrong-time errors were excluded from analysis. The frequency of errors preventable by BCMA-eMAR decreased significantly in both hospitals after implementation of that technology. BCMA-eMAR and direct observation were more effective than voluntary reporting programs at intercepting and recording errors and preventing them from reaching patients.
Authors: Kevin Klein; Joep H G Scholl; Niels S Vermeer; André W Broekmans; Eugène P Van Puijenbroek; Marie L De Bruin; Pieter Stolk Journal: Drug Saf Date: 2016-02 Impact factor: 5.606
Authors: Daniel C McFarlane; Alexa K Doig; James A Agutter; Lara M Brewer; Noah D Syroid; Ranjeev Mittu Journal: PLoS One Date: 2018-05-16 Impact factor: 3.240