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Bar codes a prescription for safety

A hand-held scanner to scan a patient's ID wrist band with a new electronic system before giving him his medications.

A hand-held scanner to scan a patient's ID wrist band with a new electronic system before giving him his medications.

When it comes to giving medications to patients, nurses must heed the five “R”s: right patient, right drug, right dose, right route, right time.

St. John Medical Center this week began using a new electronic tracking system to ensure the staff gets all those “rights”, well, right.

In its intensive care unit, the hospital began using the Bar Code Medication Administration, which has been proven to reduce hospital medication errors, St. John officials say.

“It’s just yet another tool, another safety net to cut down on human error,” Peggy Malone, St. John clinical nurse specialist and nurse educator, said Wednesday.

When patients are admitted to St. John, a bar-coded identification band is placed on their wrist. The bar code includes the patient’s name, date of birth and medical record number. After a doctor has determined what medications the patient needs, the pharmacy enters that information into the patient’s electronic file.

When it’s time to give medications , the nurse uses a hand-held scanner to scan the bar code on the patient’s wrist, then scans the bar code on the medication packaging. The system electronically compares the patient’s identity and medication information. Alerts will appear any time any of the five rights are jeopardized, alerting the nurse of any potential discrepancies or mismatches.

After the medication is given, BCMA automatically records it on the patient’s electronic chart, eliminating the need for the nurse to manually chart the effort – another area of potential human error.

Malone said using the intensive care unit as a start-up for BCMA will put the system to a tough test.

“We figured if we could do it successfully here, because of the complexity (with patients’ medications), it would easily work elsewhere,” she said.

Training of the nurses using BCMA takes only about 30 minutes, Malone said. “It’s not much different than what we’re already doing. It’s a matter of noting where this new information is on the computer screen.”

BCMA was first implemented in the Veteran Medical Center in Topeka, Kan., in 1995. It was conceived of by a nurse who was inspired by a car rental service using bar code technology.

Use of the technology at the patient’s bedside has shown gains in reducing medication errors, which may account for as many as 7,000 deaths per year in U.S. hospitals, according to the Institute of Medicine. Studies in VA hospitals in the 1990s showed use of bar codes reduced medication administration error rates by up to 86 percent.

St. John’s birthing center will be online with BCMA the first part of February, Malone said, followed by other inpatient floors. “I think everybody will be actually using it by March 30,” she said.

St. John Medical Center is the second PeaceHealth hospital to use BCMA. Ketchikan, Alaska, has been using the system since October.