bcma patient safety report

Abstract Near-miss event reporting and analysis is an essential part of a robust patient safety program. Pennsylvania has seen an increase of more than 2,700% in reports of near-miss barcode medication administration (BCMA) events over twelve years, from January 2005 through December 2016.

Full Answer

What are some potential patient safety issues associated with BCMA?

More important, potential patient safety issues exist because a complete record of medications is difficult or impossible to achieve. Second, BCMA is inoperable or nearly inoperable for 30–60 minutes twice a day every day for refreshing/maintenance.

Do you include pertinent symptoms in BCMA?

Pertinent symptoms are not always available in BCMA for scheduled medications. Although some nurses will jot a word in the medication comments about the patient having symptoms such as nausea or constipation, this practice is not consistent.

How do I search for a patient in the BCMA?

At the BCMA – Patient Select dialog box, enter one of the following search criteria in the Patient Name field: • Patient name (Last, First) • Patient Social Security Number (SSN) • Rm-Bed • Ward TIP: You can also enter the first letter of the last name and the last 4 of

How do nurses report missing medications in BCMA?

Nurses have to memorize information or repeatedly toggle through the tabs. As for missing medications, nurses can run a report in BCMA for medications due or missed medications for each individual patient, but the list only contains Unit dose and IVP/IVPB medications rather than the full set of medications.

What is BCMA compliance?

A number of healthcare systems have invested in bar code medication administration (BCMA)—an inventory control system that uses bar codes in hospitals and pharmacies to prevent human errors in distributing and administering patient medications.

What is BCMA in healthcare?

Bar Code Medication Administration (BCMA) is a point-of-care application for validation of medication administration that supports "real-time" recording of medications given to hospital inpatients.

What is the BCMA process?

Bar code medication administration (BCMA) systems scan a patient's wristband and medication to be given in order to prevent medication errors. Preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings.

How can I improve my BCMA compliance?

Interventions such as raising awareness of the importance of this measure, securing leadership support, targeted individual staff education, and identifying and addressing barriers to scanning are tools that can be successfully implemented to in-crease compliance.

How is BCMA measured?

The levels of membrane-bound BCMA can be measured by various techniques (e.g., flow cytometry, immunohistochemistry), with flow cytometry being more sensitive than immunohistochemistry, though the quantification of BCMA levels can differ between studies owing to differences in methodology [7, 23, 28].

When was BCMA implemented?

BCMA was first implemented in 1995 at the Colmery-O'Neil Veteran Medical Center in Topeka, Kansas, US. It was created by a nurse who was inspired by a car rental service using bar code technology. From 1999 to 2001, the Department of Veterans Affairs promoted the system to 161 facilities.

What are the 5 rights of administering medication?

One of the recommendations to reduce medication errors and harm is to use the “five rights”: the right patient, the right drug, the right dose, the right route, and the right time.

How do automated dispensing cabinets work?

ADCs are locked medication cabinets. When data are entered on digital screens (for example, user identification, item requested), only selected drawer(s) open giving users access to selected items. Each transaction is recorded electronically.

Why is bar coding an important safety measure?

Bar-coding technology adds an extra level of patient safety to the medication administration process. Using electronic bar coding can reduce medication errors, making the technology increasingly more popular in hospitals and health systems.

Does barcode scanning reduce medication errors?

The medical errors such as dosages and drugs errors can decrease in hospitals due to implementation of barcode technology. According to implementation of this technology, medication administration errors decreased in medical units [11].

How does barcode medication administration affect patient safety?

Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety.

What kinds of errors do nurses make regarding the administration of medications?

Most of the medications are administered by nurses [7]. The frequently perpetrated types of MAEs include wrong dose, wrong time, wrong drug, wrong route, omission of doses, wrong patient, lack of documentation, and technical errors [8,9,10,11].

How many hospitals have BCMA?

Nearly all reporting hospitals (98.7%) have a BCMA system implemented in at least one inpatient unit — with the vast majority of these hospitals (96.8%) using the system in all applicable units.7

What is a BCMA system?

Implement a BCMA system linked to an electronic medication administration record in 100% of the hospital’s medical and/or surgical units (adult and pediatric), labor and delivery units, and intensive care units (adult, pediatric, and neonatal)

What is an ADE in medical terminology?

An ADE occurs when a patient is harmed due to medication. In these cases, a decimal point error, overlooking patient allergies or a potentially harmful drug interaction, and/or confusing similarly named drugs could cause death or a serious injury.

Do hospitals report BCMA?

In addition, a considerable number of hospitals still do not report on BCMA usage. Additional transparency from these facilities is critical to making true patient safety gains.

Is human error a good thing?

Human error is unavoidable. The effectiveness of any technology is only as good as the effectiveness of its implementation in the delivery of care. Even when BCMA systems are well designed, problems can arise that force usersof the system to act outside of the prescribednorms. The Leapfrog BCMA standard incorporates five best-practice processes and structures to prevent the workarounds that undermine the efficacy of BCMA as a patient safety tool. These include:

Does Leapfrog have a bar code?

Most reporting hospitals have a bar code medication administration (BCMA) system connected to an electronic medication administration record (eMAR), but only one-third fully meet Leapfrog’ s BCMA standard for safe and effective implementation of the system

What are the benefits of implementing BCMA and eMarsystems?

For several grantees, one of the greatest benefits of implementing BCMA and eMARsystems was the increased ability to evaluate medication administration in their hospitals.Many applications had the ability to generate reports with detailed information such as when

What is barcoding and emar?

Similar to other health IT implementations, barcoding and eMAR technologies requiremodifications to hospital policies on medication administration and patient identification.Almost every hospital has detailed policies regarding proper workflows for nurses and otherhospital staff. Many of these policies were created in response to accreditation requirementsof the Joint Commission,15 in addition to well-publicized reports by the Institute ofMedicine on the pervasiveness of medical errors.2 Grantees reported that policies aroundmedication administration and patient identification required modification with theimplementation of BCMA and eMAR.

How many hours of training per nurse?

Grantees emphasized the importance of appropriate and effective staff training. Onegrantee originally designated two hours of training per nurse, but realized duringimplementation that this was not sufficient and increased training to four or five hours. In

What are the grantee interviews?

The grantee interviews provided detailed information about the successes, failures, andlessons learned from the AHRQ-funded implementation projects. The grantees identifiedvarious issues and challenges in the areas of technology, implementation, and organizationalconsiderations; these are described in more detail below.

Why is improving efficiency important?

Improving efficiency is a key goal for hospitals and health organizations, and manyimplement new health IT systems in an effort to increase efficiency. According to thegrantees, BCMA and eMAR systems had no impact on nurses’ workflow, and in someprojects, increased workload for pharmacy staff. Many grantees believed that BCMA and

Do drug manufacturers have to put barcodes on their medications?

The FDA ruled that drug manufacturers must put linear barcodes on their medications atthe level of the unit dose.13This mandate has made barcoding more feasible for manyhospitals. However, there are still instances in which facilities have to barcode medicationsthemselves, such as: in cases of incompatibility with hospital scanners; cases wheremedications were received without the barcode (despite the mandate); or in instances inwhich medications have to be re-packaged into smaller doses. One grantee reported that 35percent of the drugs they received from manufacturers did not have labels. Beforepurchasing a packaging and labeling machine, they had to manually affix these labels to themedications, a highly time-consuming process. Several other grantees reported purchasingstate-of-the-art packaging systems to address the increased workload associated withpackaging and labeling. Another grantee described that, in addition to using an in-housesystem, the grantee organization outsourced the majority of unit-dose barcoding to third-party organizations. While this was an effective solution for this grantee, other organizationsmay not have the financial resources to contract with an outside vendor.

How effective is BCMA?

BCMA implementation can be remarkably effective in reducing medication administration errors. A study of BCMA-eMAR implementation in an academic medical center demonstrated a 41.1% relative reduction in nontiming errors in medication administration, resulting in a 50.8% relative reduction in potential ADEs due to such errors.7 BCMA implementation in the ED has also shown a relative reduction of 80.7% in medication administration errors.8

How many deaths are caused by medication errors?

Many serious medication errors result in preventable adverse drug events (ADEs), approximately 20% of which are life-threatening.1,2 According to the Institute of Medicine’s report, To Err is Human, medication errors alone contribute to 7,000 deaths annually.3 Despite clinicians’ best efforts, over 40% of serious and life-threatening ADEs are preventable.4

What is leapfrog standard?

With the guidance of a national panel of experts in BCMA use, The Leapfrog Group developed a standard for hospital adoption of BCMA. Leapfrog’s standard focuses on four components of BCMA implementation:

Do hospitals have BCMA?

While most hospitals reporting to the Leapfrog Hospital Survey indicate that they have implemented BCMA system in at least one inpatient unit, some hospitals have not adopted BCMA or are not using it in all units. What are the challenges?