Hospital Bar Coding

Bar Coding for Medication Administration bar coding in hospitals hospital bar coding medication administration bar coding bar codes in hospitals bar coding patients

FDA web page on bar coding

Final FDA rule on bar coding

FDA's fact sheet on the final bar coding regulation

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Click here for a proven 13-step startup check list on how to begin your bar coding project.

Need a list of the latest handheld hardware and software for bar coding? Email us.

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Click here for the article titled "Fifteen Best Practice Recommendations for Bar-Code Medication Administration in the Veterans Health Administration".

An American Society for Health-System Pharmacists (ASHP) survey found that hospital pharmacy departments are better equipped to prevent errors in administration and distribution of medications than they were three years ago. Fifteen percent of hospitals use a robotic distribution system compared to 7.8 percent in 2002 and 4.5 percent in 1999. A majority of hospitals (71 percent) use automated dispensing cabinets compared with 58 percent in 2002. Almost all of these cabinets (88.9 percent) are linked to the pharmacy computer system, which ensures that nurses only have access to the medications needed for a specific patient....The use of bar-code medication administration (BCMA) to verify patient identity and the accuracy of medication administration at the point of care also saw a marked increase in 2005. Nearly ten percent of hospitals reported having BCMA systems in place, compared to 1.5 percent in 2002. Sixteen percent of hospitals with 100 or more beds used the technology compared to six percent of hospitals with 50-99 beds and none of the hospitals with fewer than 50 beds. Read more here...

Exactly how does bar coding work?

Barcodes are a series of vertical lines; when read by a laser scanner, they create electrical signals. These signals are decoded and translated into data interpretable by a computer. The data represented by the barcode is expressed in alpha and/or numeric characters, such as a drug's name, strength, and lot number. When used correctly and consistently, barcoding can reduce manual entry errors by 17%, decrease medication errors by 86%, and provide 100% positive patient identification during blood transfusion.

Use of a Medication Administration Bar Coding Point Of Care (BPOC) system entails the following steps:

The medication order is entered and sent to the computerized pharmacy system for verification by a pharmacist. The order then appears, real-time, on the bedside computer through interfacing with a dedicated server. Radio frequency allows the laptops to be wireless and portable, permitting use among multiple patient locations.
The nurse scans his/her bar coded name badge and then, enters a secure password.
The nurse scans the patient's bar coded wristband and the patient's medication administration record appears on a computer screen.
The nurse scans the applicable unit-dose-packaged medications before administering the medication. The computer then checks the database of orders for that patient and if a drug-patient-dose-time-route mismatch exists, the system generates a warning. In cases where the medication is frequently confused with another drug that looks or sounds alike, sophisticated BPOC technology warns the nurse of this potential problem.

An electronic medication administration record (EMAR) is produced automatically as an end result of the administration process; the BPOC system can offer an updated printable log for final documentation. Advanced BPOC technology includes standard reports that reflect potential errors made, potential errors prevented, and reasons why nurses over-rode warning messages.

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The American Hospital Association lists the following as some common types of medication errors:

incomplete patient information (not knowing about patients' allergies, other medicines they are taking, previous diagnoses, and lab results, for example)
unavailable drug information (such as lack of up-to-date warnings);
miscommunication of drug orders, which can involve poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations;
lack of appropriate labeling as a drug is prepared and repackaged into smaller units; and
environmental factors, such as lighting, heat, noise, and interruptions, that can distract health professionals from their medical tasks.

Here are some examples of similar drug names and reports of medication errors associated with them:

FDA, Janssen Pharmaceutica Products, and Johnson & Johnson Pharmaceutical Research & Development notify healthcare professionals of reports of medication errors involving confusion between Reminyl and Amaryl (glimepiride). MedWatch Safety Info. (Posted 10/26/2004)
Medication errors associated with flomax and volmax
Medication errors associated with zantac and zyrtec

FDA and UCB Pharma advised healthcare professionals of the risk of dispensing errors between KEPPRA (levetiracetam), an antiepileptic, and KALETRA (lopinavir/ritonavir), an antiretroviral. MedWatch Safety Information (Posted 10/9/2003)

Other

Medication errors associated with taxotere and taxol

Source of above information: http://www.fda.gov/cder/drug/mederrors/default.htm

This section was written by Marisa Barbieri, Healthcare IT Solutions Consultant, member of the patient safety bar code task force for HIMSS, member of the Patient Safety Systems committee, Health Information Business Communications Council (HIBCC), and panel member at Hospitalbarcoding.com. Email her at staff@Hospitalbarcoding.com.

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