Medication Errors in Healthcare Systems and Financial Burden
Medication errors have been identified as a major source of preventable errors in many healthcare systems. Unfavorable drug events (ADEs) create uncertainty for patients, resulting in a linear increase in financial burden estimated to be $3.5 billion per year (Reynolds, 2014).
The Impact of Medication Errors on Patient Safety
The FDA Adverse Event Reporting System (FAERS) reported 573,111 patients suffering injury from preventable accidents in 2011, with 98,518 of the adverse events resulting in the loss of life. Surprisingly, 38% of recorded deaths were linked to pharmaceutical errors. About 450,000 medication errors take place each year estimating that it would have been possible to prevent 25% of the mistakes (Goundrey-Smith, 2013).
Implementing Bar Code Medication Administration (BCMA) and Electronic Medical Record (EMAR)
It is essential that health care facilities, with this kind of challenges in mind, ought to start looking at how to implement Bar Code Medication Administration (BCMA) together with Electronic Medical Record (EMAR) to enable a reduction in medication errors.
The Role of Nursing Informatics in Reducing ADEs
This paper will focus on the concerns that relate to ADEs on nursing informatics, looking into how BCMA and EMAR can aid in the reduction of ADE. The paper will also draw conclusions on how Nursing Informatics (NI) are likely to affect in facilitating the integration of BMCA to assist in the prevention of ADE from reaching the patient.
The Cost and Causes of ADEs
Although administration of medication benefits the patients in many ways, medication errors are likely to happen at while prescribing, transcribing, labeling, dispensing or during the administration process. Nelson and Stagger (2014), estimated that the national morbidity and mortality cost of ADE's lay between $76.6-136 billion per year.
The Use of Bar Code Scanners in Medication Administration
It is suggested that a third of ADEs usually take place while the prescription is being made. Another third of ADEs happens when the administration is being done. Data confirm that the use of bar code scanners together with Electronic Medical Record (EMR), is likely to reduce or all together bring to an end the incidents and severity of ADEs. Also, the bar code scanners can reduce errors encountered while administering the wrong doses or treatment, or even giving a medication to a patient with a known allergy (Tindall, Sedrak & Boltri, 2014).
Implementation of Bar Code Scanning
Delivering medication is the outcome of a combination of a series of 10 to 15 steps starting with the placement of medication orders into the computer in form of an order entry. The pharmacist conducts the order processing which then appears in the EMR, a point at which it is possible for order the reviewing to be conducted by the nurse, retrievals of the medication done and administrations done safely. As a follow up, it is vital for the nurse to do a barcode scanning of the patient's wristband trailed by scanning the barcode on the medication allowing a verification check by the nurse and by the computer system of the five rights of medication administration. If it happens that there is a mismatch between the scanned barcode on the medication and the patient's barcode, the nurse will receive an unsafe action alert from the computer providing the nurse with an opportunity to stop the potential administration of an unsafe medication by reviewing the order and notifying the physician. This collaborative multidisciplinary approach leads to a safe medication dispensation and administration (Brixey, Brixey, Saba & McCormick, 2015). Safe care delivery environment as a Providence to patients is as a result of incorporation of information technology into health care.
Benefits and Challenges of BCMA
A six-week post implementation of BCMA brought about a reduction of medication error numbers by 50%. The Emergency Department, after the implementation of BCMA, astonishingly had reduced the number of ADEs and improved the administration accuracy from about 87% to 99% (Seibert, Maddox, Flynn & Williams, 2014). BCMA can provide alerts on overdue medications or allergies, which can reduce adverse drug reactions and missed medications.
Challenges in Implementing BCMA
Challenges faced by nurses can be attributed to changes in technology, advancements, and modifications in the processes (Globerman & Fraser Institute, 2013). It was a constant complaint by nurses that BCMA increased their workload on top of mainly slowing down the administration of medication. Angel, Friedman, and Friedman (2016), ascertains that BCMA is unable to utilize the scanning properties upon medication administration. The verbal orders still required a review by pharmacy before the clearing of the medication for scanning. The portable devices are advantageous for their ease to be rapidly moved in and out of the patient room. The challenge comes in because the hardware used together with this portable device is largely dependent on regular, unfailing wireless connectivity. The devices use a battery prone to wearing out after some time thus an exposure creation of infection control related challenges. The cost of each device is so huge because the initial implementation plans must include training of the nurses on how to use the devices despite the devices being considered cost-effective and unmatched in promoting the safety of the patient.
The Role of Nursing Informatics in Implementing BCMA
Although information technology in health and medicine systems is developed so as to improve the current workload, it is a must that the changes manifestation will be resultant to the implementation of new technology ((Bulechek, 2012). It is, therefore, important that all workers including nurses, physicians, pharmacists, and informatics work together through the implementation stage with the objective of providing better patient safety. On top of that, every worker partaking in the application process should always responsibly stick to the five rights of medication administration.
The Role of Nursing Informatics in Enhancing Patient Safety
Nursing Informatics (NI) assists in incorporating together nursing science, nursing knowledge and computer science in communication and management of data and knowledge into implementing BCMA. After implementation, NI proceeds to monitor nursing workflow, easing documentation while collaborating with interdisciplinary teams involved in EMR. Additional skills are used upon process evaluation and of the results of the newly implemented technology focusing on its design and interface are with the aim of enhancing care delivery and speeding up access to patient information and with medication orders thus reducing probable errors, promote patient safety and improve patient outcomes (Murray, 2017).
Conclusion
Conclusively, medical errors chiefly result in financial burden in healthcare secularly. It is unfortunate that almost a half of patients in the hospital might seriously be affected by ADE resulting from human error. According to studies, NI can integrate nursing science, computer science and nursing knowledge to bring about the implementation of BCMA proven to minimize medical errors while improving patient safety. The combined use of BCMA with EMR brings down medication errors thus reducing cost via stock control, waste minimization, and medication management. The aim is an improvement to the documentation of medication administration; scale down on ADEs, and record medication responsibility data resulting in an improvement in patient safety. New technology solutions are continuously coming up to facilitate an improvement in safety and reducing chances for ADE and enhancing the patient experience. Finally, technology promotes communication and collaboration, as well as closing gaps within healthcare, thus promoting improved quality patient care and as a result reducing the cost of health care.
References
Angel, V. M., Friedman, M. H., & Friedman, A. L. (2016). Integrating bar-code medication administration competencies in the curriculum: implications for nursing education and interprofessional collaboration. Nursing Education Perspectives, 37(4), 239-241.
Bulechek, G. M. (2012). Nursing interventions classification (NIC). St. Louis, Mo: Mosby
Brixey, J. J., Brixey, J. E., Saba, V., & McCormick, K. (2015). Essentials of Nursing Informatics Study Guide.
Globerman, S., & Fraser Institute (Vancouver, B.C.),. (2013). Reducing wait times for health care: What Canada can learn from theory and international experience.
Goundrey-Smith, S. (2013). Information technology in pharmacy: An integrated approach. London: Springer.
Murray, E. J. (2017). Nursing leadership and management for patient safety and quality care.
Nelson, R., & In Staggers, N. (2014). Health informatics: An interprofessional approach
Reynolds, G. W. (2014). Ethics in information technology.
Seibert, H. H., Maddox, R. R., Flynn, E. A., & Williams, C. K. (2014). Effect of barcode technology with electronic medication administration record on medication accuracy rates. American Journal of Health-System Pharmacy, 71(3), 209-218.
Tindall, W. N., In Sedrak, M., & In Boltri, J. M. (2014). Patient-centered pharmacology: Learning system for the conscientious prescriber.
