Anyone using a good electronic medication admin. system?

[suanna]

The hospital I work for has just instituted a new med admin system. Bar codes, scanners, bedside computers... and it is a nightmare! It was supposedly to reduce med errors but there are so many bugs in the system we are almost giving drugs at random! Has anyone used a electronic drug admin. that was accurate and fairly easy to learn?

[nursekatie22, RN]

The hospital I work for has just instituted a new med admin system. Bar codes, scanners, bedside computers... and it is a nightmare! It was supposedly to reduce med errors but there are so many bugs in the system we are almost giving drugs at random! Has anyone used a electronic drug admin. that was accurate and fairly easy to learn?

The one we're using sounds identical to the one you're describing and it works pretty well. It was just hard to get used to because I'd never used anything like that before, but it's pretty neat!

[All_Smiles_RN]

At my old hospital we had these med carts we pushed around with a scanner and laptop on it. We'd scan the pt's ID band and then scan the meds before we gave them. If the med didn't match the the MAR, a warning would pop up on the computer screen. I think it was a great system. I would imagine it definitely reduced med errors. It was also nice because you could "park" your cart wherever, pull up a chair, and have your own desk space for charting. Whenever I had a pt that required closer observation, I could be nearby to watch them and chart at the same time. Med scanners are a great idea in my opinion.

[shock-me-sane]

The hospital I am at is using something called BCMA which I think is barcode medication administration. Also are little PDA type things called carefusion which scans everything. They work really well.

[EmmaG, RN]

At my old hospital we had these med carts we pushed around with a scanner and laptop on it. We'd scan the pt's ID band and then scan the meds before we gave them. If the med didn't match the the MAR, a warning would pop up on the computer screen. I think it was a great system. I would imagine it definitely reduced med errors. It was also nice because you could "park" your cart wherever, pull up a chair, and have your own desk space for charting. Whenever I had a pt that required closer observation, I could be nearby to watch them and chart at the same time. Med scanners are a great idea in my opinion.

We used a similar system. I worked for an HCA hospital and it was called eMar. We were the first unit to try it out, so we got to give input on how it worked, bugs, etc.

It takes some getting used to, but it isn't that hard once you get it down. And it did help with med errors however there were some where the pharmacy had mislabeled the medication or the patients were mis-banded. There were also mistakes made when the nurse would override the computer or scan a barcode not on the patient. They fixed that so you had to scan an armband (the band codes were altered so they did not match those of the addressograph). You could still override, but there were checks put into place and it was monitored---so you best have a darn good reason for the override, because they would come and ask you why you did so.

So you can't get complacent and expect the computer to be flawless... still do your "5 rights" when you pass your meds.

[miko014]

We use McKesson Care Manager for doc orders and med admin. It's nice. It has saved my butt - you get in a hurry and say, grab the wrong vial (oops, that's ativan, not hydralazine!), etc. It only works if you use it, though. In other words, don't give the med and THEN scan the pt and barcode! That has happened with...eh-hem...scary results (not to me, thank goodness!!!). Yes, there are bugs and annoyances...a new med will be scheduled for say 1200 but won't be on the floor until 1500, etc. And our pharmacists cannot see the system we use. I don't know how they put in the meds, but their system is different from ours, which causes headaches. Then there is the whole computer situation in itself...you know, not working, etc. But when all is going well, I really like it!!!!!

[suanna]

From what I am reading most nurses like the new bar code med admin systems. Perhaps it as as I suspected - our pharmacy is a bunch of ignorant trolls. Our meds are never accurate to the orders. Frequently(at least 2-3 on every patient) there are meds TO BE GIVEN that are not ordered. The med timing seems random. Duplicate orders occur every day( med change from TID to QID will have both schedules but different times so the patient gets 7xQD if you don't watch every dose. Nursing administration tells us that pharmacy is not a nursing department and so they have no control over thier practice. It's the staff nurse once again that ends up with double the work to compensate for poor management decisions. - (sorry just ranting- I'm known for this.)

[EmmaG, RN]

Nursing administration tells us that pharmacy is not a nursing department and so they have no control over thier practice.

That's a total cop-out.

Pharmacy might not be a nursing department, but the two have to work together to provide safe patient care. IMO, nursing AND pharmacy administrations need to get their heads out of their butts, quit this grade-school blame game and get to work fixing these problems.

We kept track of problems we encountered, and then the computer people collected this info from all departments in order to 'tweak' eMar so that it was safer and more efficient.

These systems can be programmed to alert the pharmacist when entering an order that is a duplicate, or an allergy or incompatible, etc. However the programmers don't know to do this if the problems aren't communicated to them, and if nursing and pharmacy are simply pointing fingers at each other instead of cooperating, I'm afraid you're going to continue to have these issues.

I think you're being a bit hard on the pharmacists; they are licensed professionals, too. Please keep in mind this is new for them as well.

[miko014]

Do you write up incident reports when stuff like that happens? Having the same med ordered TID and QID is a med error, even if it does not reach the pt. If you start writing up this stuff, something will have to be done. A near miss is an accident waiting to happen, and when something does happen, it's going to sound pretty weak when you say, "I've been complaining about this for years!" You need to document everything that happens, and an incident report is the way to go. That brings it to the attention of the managers and all the other departments involved.