Bar Coding for Medication Administration

Group 9Heather Cason Kevin Cooper

Daron GilmoreJason Lee

Murtaza QureshiJosh Wallace

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1999 the Institute of Medicine estimates that 44,000 - 98,000 people die each year in hospitals due to medical errors, averaged that’s 1 : 3,841 US citizens

Adverse drug events accounted for up to 7,000 of those deaths

Adverse drug effects resulted in an increased average hospital cost of $4,700 per admission

Nationally the amount increases to about $2 billion 2004 FDA requires barcodes to be put on labels of

medications FDA estimates bar-code rule will result in 50% increase in

medication error detection Requirement makes hospital point-of-care administration

systems easier and less expensive

Introduction

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FDA Mandated Barcode

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Medication Dispensing Station

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BCMA is a software that utilizes barcode technologies in combination with real-time Ethernet local area network (LAN) connectivity with a centralized computer.

Was developed in 1995 at the VA Medical Center in Topeka, Kansas and went worldwide in 2000.

Background – How it works

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The BCMA enables nurses to validate and document the administration of medications.

The nurse scans her employee ID, then scans the patients wristband, then the medication is administered to the patient.

Once the scanned data is in the system it checks the system to verify the “five rights”:◦ Right patient◦ Right drug◦ Right dose◦ Right route◦ Right time

Background – Process

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The Beloit Memorial Hospital in Wisconsin implemented the BCMA in July 2003, in their Family Care Center (FCC).

Within the first 4 months they noticed a 67% decrease in medication administration errors.

After seeing the outstanding results in using the BCMA system they implemented it in their Special Care Center (SCC), Multi Care Center (MCC), Intermediate Care Center (ICC), and Critical Care Center (CCC)

Background - Trials

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Beloit Memorial Hospital did pre-implementation and post-implementation studies and found that after the BCMA system was implemented in all 5 centers they reduced their errors by 82% from Sept 03-Nov 04.

Background – Trials Cont’d

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Beloit Memorial Hospital Results

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The main purpose of the administration of Bar Coding is for the Doctor and nurses to follow the 5 rights and try to prevent more medical errors.

Overdosing and the wrong medication being administered are some of the major medical errors.

Administration

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5 Rights of Medical Administration:◦ - Right Patient – make sure that the patient is the

correct person who gets the medication◦ -Right Medicine – make sure that the medication

being administered is the correct medication the doctor prescribed

◦ -Right Dose – make sure the patient receives the correct dose amount and does not over dose

◦ - Right Time – that the medication being administered is at the right time

◦ -Right Route – goes the right route in being administered

Administration – Cont’d

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Having a BCMA implemented will document all of the information electronically instantly to the patients record.

Eliminating the retrieval and updating of paper files.

Doctors will have the patients medical records in a timely manner to help ensure the best diagnosis.

Administration – Cont’d

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Scanned Wristbands◦ If scanned wristband

does not match with bar coded medication, a warning will appear.

◦ Tells nurses whether to continue to administer medication or to stop

◦ Gives nurses important warnings and directions of use on

Safety

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Electronic Medication Administration Record◦ Automatically made

with the use of bar coding

◦ Keeps track of medication which will limit the chances of medication errors.

◦ Gives doctors a accurate electronic record to analyze.

Safety – Cont’d

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Patients Safety Eases patients

concerns More confidence in

nurses Changes will be

recorded immediately to prevent the continuation of harmful drugs

Safety – Cont’d

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Horizon Admin-Rx ◦ Hand held scanning devices to

identify patient, caregiver, and medications

◦ Interfaces with ROBOT-Rx a pharmacy information system that makes storing, dispensing, returning, restocking, and crediting of bar-coded meds automatic.

LifeCare E-mar◦ Bedside medication

administration tool and Electronic Medication Administration Record 

◦ Safety and Flexibility in medication distribution and administration

◦ Ensures the time, date, drug, dosage, and patient match

SafetyMed ◦ Through the use of bar

code scans to confirm the user, the right patient and the right medication, SafetyMed dramatically improves the medication administration process and the documentation of medication administrations.

MedCheck◦ Includes features to

facilitate the scheduling of patient visits & remote capture of documents.

Systems

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OpenVistA BCMA◦ Currently used by over

20,000 individuals, including 2,500 physicians and contains hundreds of thousands of medical records.

◦ Supports the collection of data for billing, quality management, outcomes reporting, and resource planning.

The cost of the system depends on the hospital size. In July 2008 Forbes.com reported that Brigham and Women's Hospital in Boston, MA spent $10 Million on its bar coding system.

That $10 Million price tag does not include the $1 Million annual cost of maintaining the system.

The government offers grants to help offset some of the cost to implement the bar coding system.

Systems

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An alternative to bar coding systems is the RFID tag. The use of RFID would not require direct contact or line of sight like the bar code systems.

RFID tag system works the same way it compares the patient and medication data with the file in the hospital.

The system keeps track of which clinician retrieved and administered each drug.

Alternative Systems

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7000 drug related deaths

FDA Requres Barcodes

Results in 50% Increase of medication error detection

BCMA is technology incorporating barcodes with LAN connectivity

It was developed at the VA medical Center

Resulted in 67% decrease in errors at Beloit Memorial

Conclusion

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5 Rights – Patient,Drug,Dose, Route, Time

Increase efficiency of doctors and nurses

Ensures drugs get to the right place at the right time

Improves safety

Alerts when problems occur

Creates automatic record to help in future diagnosis

Conclusion – Cont’d

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BCMA Systems Horizon Admin-RX

LifeCare E-mar

SafetyMed

MedCheck

OpenVista BCMA

Brigham and Women's Hospital spent $10 million on a bar coding system

Doesn't include $1million yearly

RFID tags could be used in same way

Conclusion – Cont’d

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Questions