Effect of barcode technology on medication preparation safety: a quasi-experimental study

Abstract

Background Medication errors are a common problem in hospitals and a major driver of adverse patient outcomes. Barcode verification technology is a promising strategy to help ensure safe medication preparation practices. Objectives The objectives of this study were (i) to assess the effects of a barcode-assisted medication preparation and administration system regarding the rate of medication preparation errors and (ii) to compare the time spent on medication preparation tasks by medical staff. Methods A quasi-experimental study with a pre–post design was conducted, from August 2017 to July 2018, in two mixed medical/surgical units of a tertiary teaching hospital. The primary aim was to assess the effects of a barcode-based electronically assisted medication preparation and administration system linked to the hospital’s electronic medication administration record regarding the rate of medication preparation errors and time-based staff performance. Data were collected using direct observation. Adjusted and unadjusted logistic models were used for error frequencies and linear regression models for time performance. Results 5932 instances of medication selection and dosing during 79 medication preparation procedures were observed. The overall medication preparation error incidence decreased from 9.9% at baseline to 4.5% at post-intervention, corresponding to a relative risk reduction of 54.5% (P < 0.001). However, the adjusted effect by registered nurses (RNs) and nurses’ work experience of total medication preparation errors showed only borderline significance (odds ratio [OR] 0.64, P = 0.051). For adjusted error-specific analyses, significant error reductions were found in wrong medication errors (OR 0.38, P < 0.010) and wrong dosage errors (OR 0.12, P = 0.004). Wrong patient, wrong form and ambiguous dispenser errors did not occur at post-intervention. Errors of omission (OR 1.53, P = 0.17), additional doses (OR 0.63, P = 0.64) and wrong dispenser boxes (OR 0.51, P = 0.11) did not change significantly. The time necessary to prepare medications for a 24-h period also decreased significantly—from 30.2 min to 17.2 min (beta = −6.5, P = 0.047), while mean preparation time per individual medication dose fell from 24.3 s to 15.1 s (beta = −5.0, P = 0.002). Conclusion Use of the new barcode technology significantly reduced the rate of some medication preparation errors in our sample. Moreover, the time necessary for medication preparation, both per 24-h period and per single-medication dose, was significantly reduced.

A computer architecture based on disruptive information technologies for drug management in hospitals

“…Management of the intra-hospital drug chain is inefficient, with a lack of transparency in some processes and not completely safe in terms of administration to the patient ( Raijada et al, 2021 ). This study has identified and collected the five main problems regarding drug management in hospitals reported in the literature, and that the authors have verified during their real work in hospitals, that is: inadequate presentation format of the data to be recorded ( Küng et al, 2021 ); current procedures must be adapted to regulatory changes; inefficient data capture procedure ( Fan et al, 2022 ); incomplete data recording ( Chien et al, 2021 ); and poor analysis of the results ( Kapetaneas & Kitsios, 2022 ). This is the first novelty of this proposal regarding the state of the art.…”

“…Currently the data required according to the regulations are the lot number and the expiration date of the drug, which must appear incorporated in the secondary package (outer package) ( Felix et al, 2019 ). However, this presentation format does not correspond to current needs ( Küng et al, 2021 ; Hsieh et al, 2021 ). This secondary package is discarded by hospital pharmacy services due to lack of identification of the individual doses, and the content is extracted either for processing or for conversion into unit doses.…”

Internet of Things as support to reduce hospital errors related to medication administration

“…Related articles Barcode Medication Administration -BCMA Refs. (Barakat & Franklin, 2020;Burkoski et al, 2019;Cabilan et al, 2017;González-Bueno et al, 2021;Kennedy & Massey, 2019;Küng et al, 2021;Mulac et al, 2021;Risør et al, 2017;Van Der Veen et al, 2018) Electronic Health System -HER Refs. (Amato et al, 2017;Biltoft & Finneman, 2018;Debono et al, 2017;Griffon et al, 2017;Jurado et al, 2018;Kirkendall et al, 2020;Pontefract et al, 2018;Reinhardt et al, 2019;Shah et al, ).…”

“…In some cases, the use of electronic registration was associated with BCMA technology Refs. (Cabilan et al, 2017;Küng et al, 2021;Mulac et al, 2021;Risør et al, 2017). Health Systems, or Health Information System (HIS), are mentioned in two studies Refs.…”

Automation of the medication process in Swiss hospitals: results of a survey

“…Barcode scanning technology is a component of ‘closed loop’ medication administration and is expected to reduce error rates by between 41% and 56% 1. In the Healthcare Information and Management Systems Society (HIMSS) maturity model, which consists of stages 0 (least mature) to 7 (most mature),2 closed loop medication administration is required to achieve stage 6 or higher.…”