Introduction
Medication errors are preventable mistakes that arise in the process of drug administration. They result in harmful consequences for the patients. These errors happen at any stage in the process of administering drugs. They can occur in various locations such as hospitals, clinics, nursing homes, and even at home while someone is undergoing medical treatment. Based on their timing, these errors can be classified into different types (Zheng et al., 2021). These types include prescribing errors, which are mistakes made by healthcare professionals when writing medicine prescription orders, such as prescribing the wrong drug, dosage, or route of administration. Transcription errors occur when prescription information is transferred to the medication administration record or other documentation. It results in the administration of wrong dosages or medications being given.
Dispensing errors are made primarily by pharmacists or pharmacy technicians during the preparation and packaging of drugs. These errors result in the wrong medication being given to patients. Administration errors happen during the processing of giving the drug to the patient. They include giving the patient the wrong drug or dosage, administering the drug at the wrong time, or using the wrong route to administer the drug. Lastly, monitoring errors also occur when healthcare providers fail to carefully monitor the patients after administering medications. As a result, they fail to notice adverse reactions exhibited by the patients (Zheng et al., 2021). These errors are caused by various factors, such as healthcare professionals’ fatigue, poor communication between healthcare teams, insufficient drug knowledge, illegible handwriting of physicians, faulty electronic health records systems, and patient-related issues, such as non-adherence to prescription instructions.
PICO(T) Question
This research paper creates a PICOT-formatted research question concerning medication errors and conducts research based on analyzing previously written work about the topic. The PICOT-formatted question states: In adult hospitalized patients, does implement barcode medication administration compared to traditional manual medication administration methods reduce medication errors over six months to one year? The research question seeks to investigate whether the implementation of a barcode medication administration strategy minimizes the occurrence of medication errors in hospitals. It compares the frequency of occurrence before and after the implementation of the technology and determines whether there is a significant decrease in occurrence over six months to a year.
Relevant sources
Evidence is found by searching various sources to answer the PICOT question appropriately. Potential sources of evidence include academic databases, which include databases that deal with biomedical literature such as PubMed, medical literature such as MEDLINE, biomedical and pharmacological literature such as Embase, and nursing and allied health literature such as CINAHL. It also consists of those that contain systematic reviews and evidence-based healthcare literature, such as Cochrane Library. Evidence is also obtained through searching for journal and peer-reviewed articles from reputable journals whose primary focus is patient safety, medication errors, and healthcare quality. These journals include the Journal of patient safety, BMJ Quality & Safety, Journal of medication safety, and Journal of Healthcare Risk Management.
Government and healthcare organizations also provide information on barcode strategies for reducing medication errors. These organizations include the World Health Organization, the Agency for Healthcare Research and Quality, and the Institute for Safe Medication Practice. Websites such as the National Coordinating Council for Medication Error Reporting and Prevention and the Food and Drug Administration provide valuable resources. Lastly, clinical guidelines and recommendations from reputable organizations such as the American Nurses Association also offer insightful evidence. During the search process, relevant keywords are used that are related to medication errors, medicine administration, and patient safety. Specific keywords such as barcode medication administration are also helpful. The inclusion criteria of the source are whether the source addresses adult hospitalized patients and barcode administration. The source also shows result analysis for a period not less than six months and not exceeding one year. It should also be written in English, and it should be within five years of publication.
Research findings
Findings from the searched literature demonstrate that implementing barcode medication administration systems (BCMA) reduces medication errors in healthcare settings. BCMA technology utilizes barcodes on medications and patient identification to ensure the proper medication is administered to the correct patient in the prescribed dosages and time. Several studies chosen from the sources showed the benefits of BCMA in reducing medication errors, such as a reduction in wrong medication error instances (Ho & Burger, 2020). It aids in preventing medication errors that result from administering the wrong medication to the patients. It does this by verifying the medication against the patient’s electronic health records, thus minimizing the probability of errors occurring due to look-alike or sound-alike drugs.
The system reduces medication dosage errors by ensuring the correct dosage is administered to patients. It matches the prescribed dosage with the dose in the medication administration record, ensuring no errors occur. It also improves medicine administration time accuracy since it provides real-time reminders to healthcare providers and patients. It reduces delays in administration, enhancing patient safety. Lastly, it enhances a culture of patient safety and vigilance among healthcare professionals. It enhances patient monitoring and prompt reporting of near-miss events and potential errors.
However, several challenges have also been associated with the system’s implementation. Technological challenges, for instance, are a significant concern since they require adequate infrastructure. It requires integration with electronic health records and adequate training for healthcare providers to ensure its effective use (Jessurun et al., 2021). Its implementation also results in workflow interruptions during the initial stages of its adoption. Lastly, healthcare providers sometimes resist changes and adopt new technologies, hindering their successful implementation.
Relevance of the findings
The findings drawn from the chosen sources of evidence are highly relevant to the study. They are also instrumental in making informed decisions relating to the PICOT question. They help healthcare professionals, administrators, and health policy makers comprehend the benefits and challenges of implementing barcode medication administration systems. They also show the system’s benefits over traditional manual medication administration (Owens et al., 2020). These benefits include increased patient safety, reduced medication errors, and improved healthcare workflow. The findings also impact resource allocation and investment decisions since they give policy-makers a superb investment idea. It also impacts staff training programs since the trainers and educators have an increased scope of coverage. The study also impacts organizations’ cultures since it helps them adopt a safety culture for their patients. Lastly, the evidence helps decision-makers to focus on long-term benefits and sustainability through implementing the BCBA systems.
In conclusion, medication errors arise in the process of drug administration. They are caused by healthcare providers, pharmacists, pharmacy technologists, or the patients themselves. Medication errors result in advance effects on the patient and may result in institutional reputation damage. However, they can be minimized by establishing barcode medication administration systems (Owens et al., 2020). These systems ensure that the proper medication and dosage amounts are administered to the right patient at the right time. They reduce these errors hence impacting patient safety positively. However, its implementation requires infrastructural changes and professional training that healthcare institutions may not welcome.
References
Ho, J., & Burger, D. (2020). Improving medication safety practice at a community hospital: A focus on barcode medication administration scanning and pain reassessment. BMJ Open Quality, 9(3), e000987.
Jessurun, J. G., Hunfeld, N. G. M., Van Rosmalen, J., Van Dijk, M., & Van Den Bemt, P. M. L. A. (2021). Effect of automated unit dose dispensing with barcode scanning on medication administration errors: an uncontrolled before-and-after study. International Journal for Quality in Health Care, 33(4), mzab142. , https://doi.org/10.1093/intqhc/mzab142
Owens, K., Palmore, M., Penoyer, D., & Viers, P. (2020). Implementing barcode medication administration in an emergency department affects medication administration errors and nursing satisfaction. Journal of Emergency Nursing, 46(6), 884–891. https://doi.org/10.1016/j.jen.2020.07.004
Zheng, W. Y., Lichtner, V., Van Dort, B. A., & Baysari, M. T. (2021). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research in Social and Administrative Pharmacy, 17(5), 832-841. https://doi.org/10.1016/j.sapharm.2020.08.001
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