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Barcode Medication Administration (BCMA)
Presented By: Amrita Singh Keneikhrienuo
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Contents Barcode Introduction Anatomy Hardware Model Software Model
Standards Advantages & Disadvantages Competencies
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What is BCMA? Electronic software application
Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computer First developed 1995 VA Medical Center Topeka, Kansas Introduced nationwide in 2000 (Wideman, Whittler, & Anderson, n.d.)
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BCMA Basic Steps Physician order received Order faxed to Pharmacy
Pharmacists edit and verify electronic orders into patient profile Pharmacy dispenses ordered medications in Bar-Coded packages Nurse accesses BMCA software on computer via log on Nurse scans unique patient bar-coded ID band
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The Five Rights of Barcode Medication Administration:
The right patient The right medication At the right time At the right dose By the right route
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Hardware Model Wireless PC BCMA Barcodes Scanner Keyboard
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Barcode Scanning Device
Light weight and comfortable hand held design Built in decoder Emits high intensity red aiming beam Trigger button The handheld scanning device is constructed of hard durable plastic resembling those seen in the grocery store. The light weight and comfortable design makes it desirable for nurses to use at the bedside. The built in decoder helps to determine the right patient, right medication, right route, right time, and right dose. The high intensity red aiming beam is also similar to that in the store. This beam scans the patient, medication, and the nurses badge to prevent medication errors. The trigger button makes it easy to scan quickly and accurately.
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Software Siemens Med Administration Check (MAC) Siemens Pharmacy
INVISION Chart-Assist Interface with LCR and PYXIS Connect ( Siemens 2005) Siemens medication administration software helps nurses at the bed side and prevents medication errors. The application is easy to use and is self explanatory allowing for user friendliness. Some of the software listed can be used in combination with MAC The goal of the future is to combine programs, improve safety, eliminate time consuming charting (paper charting) and allow for more time with the patient. The wave of the future is to allow for computerized charting and health information charting capabilities not only within hospitals, but with physicians offices as well.
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Software MAC MAC is a nursing application
Database collects, sorts, organizes, and stores information Database allows nurse to easily retrieve select and aggregate data Open MAC application using login id and password Select patient from database All patients information is stored on database The goal of MAC software is to eliminate medication errors at the bedside During Report, she is able to check patient demographics, allergies, lab values, and other information right on the screen. Patient is selected by personal census, location census, patient inquiry, or by scanning patient id bracelet.
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Figure 1. Pharmacy order-verifying software program screen displays
Panel A: A sample patient profile displayed using the characteristic text-based terminal interface. Panel B: Medication entry finishing profile for an individual drug entry.
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Standards When multiple parties or companies are involved in the ID process, industry standards are usually established The standard is not necessarily the same as the barcode symbology Barcode standards define how to use the barcode symbology in a particular situation ISBN is a standard for labeling books Periodicals that uses the EAN-13 symbology
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Usability User friendly Easily learned
Overall department satisfaction with use Access information easily Interface achieves particular goals Error tolerance
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Advantages Improves medication administration flow with online work list Checks for five rights at the point of care with bar code technology Drives online MAR documentation, charging, inventory control Uses proven point of care technology options Is designed for acute, ambulatory, long term care environment
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Advantages Provides value added clinical and operation integration
Can include assessment and process redesign consulting services Compatible with any automated drug dispensing device and drug wholesaler Assesses for pain by prompting a pain scale when administering analgesics
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Disadvantages Not foolproof
Bar codes mismatch with drug, dose, and patient at times Bar code sometimes function erroneously Unable to scan bar codes properly at times Duplicate patient identification bar codes have been scanned for multiple patients
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Disadvantages Carrying several patients pre-scanned medications on one tray Disabling system alarms to avoid disturbing their patients Unreadable bar codes Emergency Situations Time consuming Nurses are wearing multiple bar codes for multiple patients on their arms causing error.
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Ethical/Legal Issues Potential problems in regards to HIPPA
Leaving the computer in the hallway with patient name and identity exposed Nurses not logging off the software application Unethical/ethical in regards to overrides Nurses need to reexamine and be cautious when using override function. To use this option may be unethical if the wrong medication should be given and cause harm to the patient.
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Competencies Clinicians have various technological backgrounds
Users were accessible to staff every shift 24 hours Workshops are initiated Need successful completion of the course Technological backgrounds range from those with excellent computer skill to those with far lower computer literacy levels.
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Competencies Staff representatives include inpatient pharmacist, ICU nurse, ward nurse, and a nursing instructor Ongoing refresher courses offered Job shadowing Multidisciplinary cross training techniques increase staff understanding and competency
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High Beam infra-red light
Name bracelet bar-coded
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Conclusion Technology at work at the bedside Increasing safety
Increasing continuity of care Increasing satisfaction among staff Increasing communication Siemens Medication Administration Check is the wave of the future every hospital should look into this safety application to decrease medication errors. Patient safety is a priority and eliminating law suits and loss of money due to medication errors should also be a priority for all medical facilities. If the establishment could save money by eliminating medication errors monies could be used for increasing technologies within the facility.
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Functions & Responsibilities of Informatics Nurses working with BMCA
Incorporate theories, principles, and concepts from appropriate sciences and evidence based practice Integrate ergonomics and human-computer interaction principles appropriately and efficiently Systematically determine the social, legal, and ethical impact and play an active role in system improvement (McGonigle & Mastrian, 2009)
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Conclusion Decreases medication errors Decreases law suits
Regardless of some small disadvantages the application can be improved over time Opens new windows and doors for communication and safety Although there have been some disadvantages noted for this product the benefits far exceed the disadvantages. There is room for improvement so eventually the system may become flawless Regardless of these disadvantages nurses are overall happy with this technology.
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References Technology for Long Term Care. (2008). Barcode Medication Administration. Retrieved February 15, 2009, from Technology for Long term Care Web site: McGonigle, D., & Mastrian, K. (Eds.). (2009). Nursing Informatics and the Foundation of Knowledge. Mississauga, Ontario Canada: Jones and Bartlett.
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