THE ROLE OF TECHNOLOGY IN THE MEDICATION-USE PROCESS

Technology and Healthcare Primarily used of data input to increase each department’s efficiency with the financial accountability measures . Influences on the Adoption of technology (JCAHO) Joint Commission on Accreditation of Health Care Organization and (NQP)National Quality Forum are presently refraining from uniformly requiring its adoption .

VA is the only health care system that has fully adopted bar coding technology Computerized Prescriber Order Entry (CPOE) A system used for direct entry of one more types of medical orders by a prescriber into a system that transmits those orders electronically to the appropriate department . Medication Administration Record (MARs) Derived from one system ,which doest not correlate with the other , lead to discrepancies in medication profile as well as possible loss of

double checks between drug distribution and administration if electronic MARs come from CPOE and not from the pharmacy order entry system Medication errors - such as a wrong pt errors, wrong drug errors -,when medication is selected from a list due to look-alike similarity in either the brand or generic name or orders intended for laboratory levels

Bar Code – Enabled Point of Care Technology (BPOC) the system helps to verify that the right drug is being administered to the right patient at the right dose by the right route and at the right time Additional levels of functionality can include the following features : Increased accountability and capture of charges for items such as unit – stock medications.

Up - to - date drug references information from online medication references libraries. Customizable comments or alerts and reminders of important clinical actions that need to be taken when administering certain medications Monitoring the pharmacy and the nurse’s to response to predetermined rules or standards in the rules engine such as alerts or reminders for the pharmacist and the nurse Reconciliation for pending or STAT

Capturing data for the purpose of retrospective analysis of aggregate data t monitor trends Verifying blood transfusion and laboratory specimen collection . 5 significant negative effects in implementation of BPOC System include : Nurses were sometimes caught by the programmed automated actions taken by the BPOC software

Nurses found it more difficult to deviate from the routine medication administration sequence with the BPOC system. The BPOC inhibit the coordination of pt information between the prescriber and the nurses when compared to a traditional paper based system . Nurses felt that their main priority was the timelessness of medication administration . Nurses used strategies to increased efficiency that circumvented the intended use of BPOC .

National Drug Code – a medical code set that identifies prescription drugs and some OTC products Uniform Code Council (UCC) and Health Standards Business Communication Council (HIBCC) Standard s – the bar code that contain not only the product’s NDC number but the expiration date and lot number are optional

BPOC System Medication Error include the ff: Omissions Extra dose Wrong drug Wrong dose Unauthorized drug Charting errors Wrong dosage form

Automated Dispensing Cabinets - is a computerized point-of -use medication- management system that is designed to replace or support the traditional unit-dose drug delivery system Wide acceptance of ADCs are the ff: Improving pharmacy productivity Improving nursing productivity Reducing Costs Improving charge capture Enhancing patient quality and safety

Unsafe practices with the use of ADC The lack of pharmacy screening medication order prior to administration Choosing of the wrong medication from an alphabet pick list ,common contributing factor in medication error arising from medication names that look alike High alert medication placed , stored , and returned to ADCs are problematic Storage of medication with look-alike names and /or packaging

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