Last week we celebrated Nurses Week at UTMB, and I had the great opportunity to “Walk a Mile” in the shoes of Bill Morey, RN in the Acute Care for the Elderly (ACE) Unit. As we talked, our conversation touched on the new barcode medication administration program that will begin on Tuesday, May 13, 2014 at UTMB. After our conversation, I thought it would be a good idea to tell everyone at UTMB about this exciting development and why we are doing it.
Why are we implementing barcode medication administration?
The primary reason we are implementing barcode medication administration at UTMB is to increase safety for our patients. The barcode medication administration system is an important step toward achieving the Health System’s goal to become known nationally and globally as a value-driven leader in health care delivery by achieving and sustaining superior performance in clinical outcomes, quality and patient safety, a goal that also supports UTMB’s institutional strategy as outlined in “Road Ahead”.
Is there evidence that supports the use of bedside barcode medication administration to improve patient safety?
In 1999, the Institute of Medicine (IOM) issued a call to action for hospitals, titled To Err Is Human, to improve the processes used in delivering health care in the United States and to reduce the number of deaths from preventable medical errors in our hospitals. One of the most avoidable errors, and an IOM recommended strategy for error reduction, was to implement safety systems, such as barcode medication administration, to improve patient safety in our hospitals. The use of barcoding to support medication administration has been demonstrated in a number of studies over the years to reduce errors by as much as 50 percent.
How often do medication errors happen?
Medication errors in hospitals are common and often lead to patient harm. In fact, one study showed that out of every 100 patient admissions, 6.5 adverse events are related to medication use; more than one-fourth of these events were due to errors and were therefore preventable. About one-third occurred at the time the medication was ordered, another third occurred at the time the medication was given to the patient, and the remaining third occurred during the transcription and/or dispensing stages.
What is the goal of the project?
Simply put, we want to protect our patients and assure their safety while they are in our care. The goal of barcode administration is to make sure that patients are receiving the correct medications in the correct doses at the correct times by electronically validating and documenting medications. The information recorded through the use of the barcodes allows for the comparison of the medication that is being administered with what was ordered for the patient.
How does barcode medication administration support provider order entry?
UTMB Health began medication safety improvement efforts in 1994 with the implementation of provider order entry in our Invision system. In 2005, we transitioned to the order entry components of Epic, and at that time we also began to use their pharmacy system and the electronic medication administration record. At this point, the provider’s order directly drove both the dispensing of medications and the documentation of their administration. The implementation of barcode technology to support the administration process will be the last step in closing the medication delivery loop by extending the same system containing the provider’s original order to serve as a safety net at the point of care. It reduces the risk of error through transcribing the order into the pharmacy system. The barcode medication administration program at UTMB will initially cover more than 80 percent of all medications dispensed.
Although this technology will not, nor is it intended to, eliminate medication errors entirely, and cannot replace the diligence and critical thinking of the nurse, it is simply a safer way for UTMB to provide high quality care for our patients in environments that have frequent distractions and elevated levels of stress. Barcode medication administration is another way that UTMB Health is working together to work wonders!