Effect of barcode technology with electronic medication administration record on medication accuracy rates

• Published in: American journal of health-system pharmacy Vol. 71; no. 3; pp. 209 - 218
• Main Authors: SEIBERT, HEATHER H, MADDOX, RAY R, FLYNN, ELIZABETH A, WILLIAMS, CAROLYN K
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society of Health-System Pharmacists 01.02.2014; Copyright American Society of Health-System Pharmacists, Inc. All rights reserved; American Society of Health Pharmacists; Oxford University Press
• Subjects: Ambulatory Care; Bar codes; Biological and medical sciences; Dosage and administration; Drugs; Electronic Data Processing - methods; Emergency Service, Hospital; General pharmacology; Health aspects; Hospitals, Community; Humans; Intensive Care Units; Medical sciences; Medication errors; Medication Errors - prevention & control; Medication Errors - statistics & numerical data; Medication Systems, Hospital; Miscellaneous; Pharmacology. Drug treatments; Prevention; United States; Drug; Delivery system; Treatment; Medication error; Technology; Toxicity; Bar code; Electronic medical record
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp130332

PURPOSEThe effect of barcode-assisted medication administration (BCMA) with electronic medication administration record (eMAR) technology on the occurrence of medication administration errors was evaluated. METHODSA 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. RESULTSThe 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). CONCLUSIONImplementation 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.