Bar Code Medication Administration NICU Style

[Mags4711]

Hello everyone!

My institution (teritiary care, Level IIIc NICU) is moving to scanning for med administration soon. I have been charged with the task of polling other NICU's to find out how you all "really" do it.

I know ideally you are to affix a barcoded ID band directly on the patient and scan that. However, we all also know that reaching scanner wands into incubators isn't the easiest thing to do, we also know the itty bitty ones generally don't have ID bands placed on their bodies, etc. Additionally you don't want to unwrap a sleeping infant to get to their ID band on their ankle.

So what do you all *really* do?

Do you actually scan the ID band that is on the baby's body? If so, where do you place the band? Do you always place it on the wrist?

Do you have an extra ID that you affix to the end of the bed that you scan?

Do you have a certain type of ID band that may have more of a "luggage tag" appearance that you make sure is hanging out of the blanket when you wrap the infant?

Do you place your ID bands on the connector for the Pulse Ox or ECG leads?

Do you print out some scannable sheet and tape it to the front of the bed and scan that?

Thank you VERY much for your responses!

[TiffyRN, BSN, PhD]

The unit where I work is not very strict about the bands being on the infant and I find this unfortunate as I think we are subverting a great safety feature. I've seen lots of times where the med band is in the kid's supply drawer, or taped to a computer on wheels close to the infant. Just unneeded risk there.

Fortunately, it's becoming more common for people to attach the band to the kid's leads, so it's essentially attached to the infant. We even have these extensions called tethers (I call them leashes all the time) that allows you to easily swaddle the infant and leave the med tag hanging out. It also gives some lee-way so if your kid is very sensitive, you could actually poke the med tag out through the giraffe access ports (where IV lines and monitor cords usually go) and therefore scan the infant without even opening the port holes.

We've improved a lot about scanning all our meds, except maybe compounded butt creams, sorry, I don't scan those!

[HyperSaurus, RN, BSN]

Our babies are banded and technically you are supposed to scan their band, but usually we just either scan their chart or a sticker we put on our brain sheet. Most of our medications we have to have another license (RN or LPN) scan their badge as a witness to our meds (right dose, ect)--cardiac meds require two licenses to witness.

[erinhrn]

We have the baby's band with barcode taped to the isolette or crib. The bands are way too big to put on them and we have never had a problem with scanning/medicating the wrong baby. We have mostly private rooms though, so that cuts down on the chances of mixing up patients.

[Jory, MSN, APRN, CNM]

We have an ID on the baby's body plus a duplicate taped on the inside of the isolette...that's the one we really use. The other is for inspections. It is signed by two nurses and anytime the isolette is changed two nurses verify it again.

[dseem13]

We put 2 ID bands on every baby using poseys. The first goes over the pulsox to keep it in place on their hand/foot, and the second goes on the small ecg lead box (no need to unwrap the baby this way).