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Medication
administration is one critical responsibility of nursing staff within the
hospital setting. If medications are not carefully administered, patient safety
can be compromised. The increase of medication errors has facilitated the
development of medication administration software. Advanced technological
capacities, such as bar-coding, reduces medication errors and increases patient
safety.  When a barcode is scanned, the
medication is identified, and dosing errors can be recognized. Research studies
suggest that healthcare technology provided many benefits including maximizing
patient safety.  A summary of these
findings will be discussed in my research below.

Clinical
Problem

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Will
the implementation of bar coding patient medications change the amount of
errors in hospitalized adults?  Without a
barcode, the probability of medication errors increases because of human error.
Due to the prevalence of medication errors, studies have been performed which
prompted the introduction of bar coding software. Studies have shown that
bar-coding has become essential, but nurses must continue to review and verify
medications by using the five rights. These include the right patient, drug,
dose, route and the right time prior to administration.  The implementation of technology based
medication administration has created an additional validation measure that
nurses should actively utilize.  The
purpose of this study is to support that the implementation of bar coding will
reduce medication errors within the hospital setting.

 

 

 

PICO
Question

Are
hospitalized adults who have had their medication scanned by a nurse by using
the bar-code system before administration at a lower risk for medication errors
opposed to hospitalized adults who did not have their medications scanned?  Medication errors have become one of the
causes of death in some patients and through research and evidence we see that
this has affected the level of care and patient satisfaction in many hospitals.
According to Gann(2015) “Death due to medication errors became the eighth
leading cause of mortality in the United States” (p.60) Because of this problem
healthcare technologies have made changes and incorporated bar codes on
medication to decrease errors and make it safe. Having this technology for
medications will secure that patient’s medication will be correctly
administrated compared to when this technology did not exist. Poon et al.,
(2010),  states that ” the use of
bar-code eMAR substantially reduced the rate of errors in order transcription
and in medication administration as well as potential adverse drug events.”(p.698)

Search
Terms

The database used to
research the evidence was: EBSCO HOST, Health Source: nursing/ Academic Edition.
The search terms used were bar code, medication, errors, nursing

 

 

Literature
Review

The
implementation of bar coding medications has reduced the number of errors.
According research studies healthcare technology has introduced a system that is
helping with the problem of medication errors. Reducing the amount of
medication errors within hospitals will 
increase in the safety of our patients. Fowler, Sohler, & Zarillo
(2009) state that, “Using a bar-coded administration system provides a safe
mechanism for delivering medication throughout the entire process, from
medication ordering to patient consumption.”(p.109) In one study done by Sakushima,
Umeki, Endoh, Ito, & Nasuhara resulted in a total of 2867 errors found in a
university hospital in which they electronically reported wrong drug
administration, but after the implantation of bar coding it significantly
decreased. ( 2015). Bar-coding has becoming an important technological tool in
the healthcare system as this new system came about so did the need for
training and practice come with it. This new implementation has brought
positive results, but with that comes the hard work to start implementing this
in all hospitals which did take some time and effort. As we know when something
new is brought into place in a work place it takes time to adapt and learn how
to correctly use a tool that will be beneficial to the work area. “A change in
any medication administration system is a multidisciplinary process that
requires members of the health care team to make adjustments and thoughtfully
plan for successful implementation.” (Fowler, Sohler,& Zarillo, 2009, p.
108). Literature reviewed indicates that using barcode medication administration
greatly decreases errors in medication administration. “Veterans Affairs
medical center reviewed medication error reduction at 1 and 5 years post bar
coding medication administration implementation and reported medication error
reduction of 23% and 66% at 1 year and 5 years.” (Coye, Heinen, 2005).

 

Practice Recommendations

Upon
my research there are three practice recommendations. The first one is from the
journal article titled “Time Trend of
injection drug errors before and after implementation of bar-coded verification
system”. In this study they reported medication errors before and after the
use of bar coded medication and detected 2867 errors related to injected drugs
in a university hospital. This should that the implementation of a bar coded
system is effective for preventing and decreasing the amount of errors in a
hospital. “Health care information technology can play an important role in the
prevention of medical errors caused by human factors. “Recently, the bar code
has become a useful tool for patient management, especially in terms of medical
safety, throughthe use of bar code medication administration at hospitals.” (Sakushima,
Umeki, Endoh, Ito, & Nasuhara, 2015, p.268). The second recommendation, was
done by Paoletti, et al., in where they used a direct observation technique in
which two different nursing units participated, a 20-bed cardiac unit, a 36-bed
medical surgical unit. It concluded that “A 54% reduction of medication
administration errors was observed following implementation of
multidisciplinary, collaborative approach to medication safety.” ( Paoletti et
al., 2007, p. 536). I see through this study that using a barcode system does
have a major impact in a hospital setting and will not only benefit the
patients but the nurses. The third and last recommendation comes from a research
titled “Bar-code Technology for
Medication Administration: Medication Errors and Nurse Satisfaction” in
this article the authors find research from other studies that show how bar
code mediation has helped hospitals decrease the amount of medication errors.
In one report it concluded that it was another useful tool to use beside the
five rights. Fowler, Sohler & Zarillo state that “Point of care
administration of medication with bar-coded scanning allows verification of the
five rights of medication administration( Sakowski et al., 2005)

Conclusion

In
conclusion, there are many errors that occur in hospital, but medication
administration is one of the errors that can be avoided by using more than just
our own eyes but by using technology together. The research from my evidence
has shown that using a bar-coding medication administration system has improved
death rates and the quality and safety of the patients in hospitals. Technology
within healthcare has become imperative to daily operations within the healthcare.

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