Medical facilities can reduce patient medication errors by using bar-code technology with an electronic medication administration record (eMAR), according to a new study published in The New England Journal of Medicine.
Medication errors are among the most common medical errors. Errors involving prescription drugs, over-the-counter products, vitamins, minerals or herbal supplements harm at least 1.5 million people every year, says a 2006 report from the Institute of Medicine of the National Academies.
Drug errors can occur due to poor verbal communication, illegible or incorrect handwriting or abbreviations, similar drug names, improper or inaccurate labeling, misuse of zeros or decimal points, out-of-date drug information, incorrect mixing or measuring, dosing unit confusion, incorrect patient or medical professional’s lack of proper training.
“Medication errors in hospitals are a very serious issue and can often lead to patient harm," said Agency for Healthcare Research and Quality (AHRQ) Director Carolyn M. Clancy, M.D. in a press release. "The good news from this study is that using bar-code technology and an electronic medication administration record together can be an important intervention to help achieve medication safety."
Simply put, bar-code eMAR makes sure the correct patient receives the correct dose of the correct medication at the correct time. Using this system, the pharmacist sends approved medication orders from the physician to the patients chart electronically. Nurses are required to scan the bar-code on the medication and the bar-code on the patient’s wristband before administering the drug. The system will warn the nurse if the two bar-codes do not match or if it is not time for the next dose. It will also notify the nurse if a patient’s medication is overdue.
This system reduces transcription and medication errors such as wrong drug errors, wrong dose errors and wrong timing errors, thereby preventing potential adverse drug events in the patient that can be fatal.
The study funded by the U.S. Health and Human Services’ AHRQ and conducted by researchers at Brigham and Women’s Hospital in Boston, compared 6,723 hospital medication administrations before installation of bar-code eMAR and 7,318 medication administrations after the system installation.
"After implementing that new system, we found dramatic reductions in errors made during the process of administering medications," lead study author Eric G. Poon, M.D., M.P.H., of Brigham and Women’s Hospital said in a HealthDay News article.
Researchers found the bar-code eMAR system reduced drug administration errors not related to timing by 41% and the potential drug-related adverse events associated with this type of error by 51%. Wrong timing errors in which the nurse administered the medication more than one hour off dosing schedule were reduced by 27%.
"Our study shows that this combination of technologies can make the delivery of hospital care safer. However, hospitals need the right set of resources and human talent to deploy these technologies successfully, so more research is needed to identify ways to implement them in the most cost-effective way," said Eric G. Poon, M.D., M.P.H.