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Whittler, and Timothy M. Abstract An electronic barcode medication administration system was successfully implemented in the acute care and long-term care sections of a bed Veterans Administration hospital beginning in February Known as Barcode Medication Administration BCMAthe software was designed to improve medication administration accuracy and to generate online patient medication records.
The nationally implemented Barcode Medication Administration software enables users to document electronically the administration of medications at the bedside, or where other points of care are involved.
Barcode technology and real-time network connectivity are used to improve the accuracy of medication administration. The barcode software implementation proved problematic in the bed intensive care unit ICU for a number of reasons, including a lack of functionality related to the documentation of intravenous fluid administration and the need for immediate software access for urgent medication documentation.
Department of Veterans Affairs' programmers made additional enhancements to the software and the BCMA program was re-implemented in November of Staff and management confidence in the enhanced software remained weak following the re-implementation, so a system of dual documentation for medication administration was maintained for a period of 12 months.
A multidisciplinary group also was convened to facilitate the resolution of issues related to the use of BCMA for the safe administration and documentation of medications prescribed for patients following open-heart surgery. This complex patient population was selected purposely because delays in critical medication administration can produce life-threatening results.
Solutions identified in the treatment of such priority patients would lead to improved care for all ICU patients. Barriers to eliminating paper record documentation will be discussed, as will the types of support needed by nurses and pharmacists in the safe transition to electronic barcode medication administration in an ICU setting.
The particular ICU setting described in this study is a combined medical-surgical unit that provides care for approximately open-heart surgery patients per year.
Introduction Medication errors are a serious public health threat. According to a landmark Institute of Medicine report, between 44, and 98, Americans die annually due to medical mistakes.
Food and Drug Administration FDA ruled on April 4,to make barcodes mandatory on the labels of thousands of human medications and biological products by the year Equally important, as the use of medication barcode technology grows, the health care institutions will need to be mindful of related changes in accreditation and compliance policies that are certain to occur within several regulatory organizations, including the Joint Commission on Accreditation of Healthcare Organizations JCAHO and the National Committee For Quality Assurance NCQA.
This article is intended to explore a few of the key lessons learned during the implementation of a barcode medication administration BCMA system in an intensive care unit ICU at the Harry S.
Human factors issues, verbal communication, and the need for adequate administrative and technical support for nurses and pharmacists during such a transition will be discussed.
Although it is recognized that the accuracy and clinical appropriateness of computerized physician order entry by providers has a significant potential impact on BCMA functionality and patient safety, this article focuses instead on those issues relevant to the BCMA software end-users. The system was first developed inat the VA Medical Center in Topeka, Kansas, and was introduced nationwide in It is modified and upgraded on an ongoing basis to meet the general needs of all the VHA medical centers.
A sample patient profile displayed using the characteristic text-based terminal interface.
Medication entry finishing profile for an individual drug entry. The Virtual Due List Figure 22 is the electronic counterpart of a Medication Administration Record MARand is used to display medications and the appropriate administration time frame for each.
Key components include the medication administration route tabs 1the Virtual Due List for medications 2more As a handheld barcode reader registers each medication, the software verifies the correct medication was ordered, administered on time, and measured in the correct dosage, while at the same time documenting the actual administration of the medication.
The acute care and long-term care areas at the bed Harry S. The hospital's ICU is a bed combined medical-surgical unit that provides care for approximately open-heart surgery patients annually.
The initial BCMA software implementation in March of was problematic for several reasons, including the software's limited ability to document intravenous fluid administration and other limitations related to the timely processing and documentation of urgently needed one-time medications.The truth is that writing is a talent and only a few people are privileged with it, but it can also be learned and anyone can be almost as creative as a writer with inborn talent if one pays attention to certain rules and thinks in an organized manner.
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