Bar Code Medication Administration in Clinic SettingWhile Emory Healthcare’s hospital systems and outpatient cancer center (Winship) implemented bar code medication administration (BCMA) in fiscal year 2014 (Emory Libraries and Information Technology, 2016), the Emory Clinics have yet to do so.
In accordance with Emory Healthcare’s system wide use of Cerner, Emory Clinic would benefit significantly from implementation of Cerner’s BCMA system. This paper will discuss this implementation, rationale for use, functionality, return on investment (ROI), feasibility, potential issues, and relationship to safe, timely, effective, efficient, equitable, and patient-centered care (STEEEP) analysis.Overview of Technology, Users, Uses, and VendorBCMA is an electronic scanning system utilized in healthcare for compliance with the Five Rights of Medication Administration. The Five Rights of Medication Administration are the right 1) patient, 2) medication, 3) route, 4) time, and 5) dosage. Users of BCMA include the healthcare professional administering the medication and pharmacy staff. A nurse, or other healthcare provider licensed to administer the medication, scans the bar code on the patient’s wristband to verify the right patient. The nurse then scans the bar code on the medication to verify the right medication, dose, time, and route before administering.
Usually, BCMA is used in conjunction with electronic medication administration record (eMAR) systems. An eMAR serves as the communication tool that automatically documents the medication administration into the electronic health record (EHR). Conjoining BCMA and eMAR allows medication administration information to be captured much faster than manual documentation. BCMA systems are also utilized by pharmacies for stocking and retrieval processes, to help avoid dispensing errors (Leapfrog Hospital Survey, 2016). Cerner is the vendor currently utilized for Emory Healthcare’s eMAR and inpatient BCMA services, and would be the logical vendor for23BCMA IN CLINIC SETTINGThe Emory Clinic’s implementation of BCMA as well. Cerner, founded in 1979, serves as one ofthe leading publicly traded information technology companies and was ranked number one in ambulatory EHR for interoperability, connectivity, and communications in 2016 (Cerner Corporation, 2016).Rationale for UseMedication administration is a complex process that requires safe and correct performance of multiple steps. Each step allows opportunity for error, due to complexity, interruptions, using a workaround, or not following the Five Rights of Medication Administration.
Errors lead to patient harm through adverse events and complications and also cost the nation $2 billion each year. Approximately 7,000 deaths occur annually due to preventable medication errors. BCMA is a technology solution strategy for reducing these medication errors (Bowers, et al, 2015).In every healthcare setting, patient safety is the most important foundational concept in provision of care. Utilization of BCMA significantly reduces errors associated with medication administration and therefore allows for safer care.
When a unit using BCMA was compared with a unit not using BCMA, the unit using BCMA had a 41.4 percent reduction in timing errors with medication administration. The incidence of medications to be administered either early or late decreased by 27.3 percent. There was also a 48.5 percent reduction of potential adverse events with a severity rating of significant, a 54.1 percent reduction in those rated serious (Poon et al., 2010).