Safe Drug Administration using the Bar Code Scanning System

Safe Drug Administration using the Bar Code Scanning System

Introduction

Over the past few years, hospital organizations have increasingly looked to new technology solutions to improve patient safety. Barcode technology is an especially promising approach in the effort to reduce medical errors. While barcode technology has been used for quite some time in many hospital applications, it has only recently been used to address patient safety. The use of barcode technology at the patient's bedside has shown impressive gains in reducing medication administration errors, which may account for as many as 7,000 deaths per year in U.S. hospitals (IOM, 2000).

Barcodes provide a valuable verification of medication administration by assuring that the "five rights" are confirmed — right patient, right medication, right dose, right time, and right route of administration. While studies conducted in VA hospitals in the early 1990s showed that the use of barcodes reduced medication administration error rates by up to 86% (Meadows, 2003), community hospitals are just beginning to use this technology to improve patient safety. Recent estimates indicate that only 2% to 6% of hospitals are currently using barcodes to reduce medication administration errors (Center for Business Innovation, 2004).

Background

This case study examines the use of a wireless, mobile barcode medication administration system at Beloit Memorial Hospital in Beloit, Wisconsin, a 175-bed community hospital with four off-site clinics, serving a population of approximately 175,000 residents living in southwestern Wisconsin and northwestern Illinois.

The hospital has a formal affiliation with the University of Wisconsin Hospital System and an active though informal affiliation with Rockford Hospital in Rockford, Illinois. The hospital's Board of Trustees, composed of 10 medical professionals and community leaders, has committed the hospital to a primary goal of providing high-quality healthcare services for all patients.

In September 2003, Beloit Memorial installed a wireless, handheld barcode medication administration system in its Family Care Center (FCC) unit, consisting of 35 ob/gyn, pediatric, and labor/delivery beds. This pilot resulted in a 67% decrease in medication administration errors within the first four months of operation. With the pilot successfully completed, the hospital expanded implementation of the barcode system to four additional inpatient units. This case study documents Beloit's experience in these units, which included (Work, 2004):

Special Care Center (SCC) Oncology

Multi Care Center (MCC) General Medical Surgical

Intermediate Care Center (ICC) Telemetry

Critical Care Center (CCC) Critical Care

These units presented a more complex environment than the FCC, treating patients with generally more serious medical conditions, who often required more medications. Consequently, these units were more prone to experience medication administration errors.

Goals and Objectives

The main goal of this study was to identify and measure the benefits of a wireless barcode system to reduce medication administration errors. To address this goal the following specific objectives were established:

Conduct an onsite visit, both pre- and post-implementation of the wireless barcode system in the four new inpatient units.

Determine pre- and post-implementation medication administration error rates in these units.

Methodology

Pre- and post-implementation site visits were conducted by an independent consultant who interviewed senior nursing management, the unit ...