Bar Code Medication Administration NICU Style

  1. 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!
    •  
  2. 16 Comments

  3. by   katierobin23
    We attach a crib card with a patient label on it to the bed to scan. Even if the baby has ID bands on (most do, but the little ones have them taped to their beds) they are hand written and we don't put labels on them.
    I'm glad we don't have to scan the babies themselves, I wouldn't feel comfortable handling the baby and the dirty scanner at the same time. I like to scan everything, use purell, then touch the baby.
  4. by   cayenne06
    I don't work in the NICU but we tape our babies' ID bands onto their bassinet. I can't imagine that it would be a good idea to stick the scanner into the incubator. Talk about a potential fomite, even though it's not technically supposed to touch the patient!
  5. by   NicuGal
    We put a sticker on the computer monitor at each baby's bedside. When we know an inspection is coming we slap a sticker on their ID band. We had luggage style ones...too big and were paper cutting the kids!
  6. by   katierobin23
    Quote from NicuGal
    We put a sticker on the computer monitor at each baby's bedside. When we know an inspection is coming we slap a sticker on their ID band. We had luggage style ones...too big and were paper cutting the kids!
    We used to do this, but infection control had a fit and our managers put an end to it. We just put a sticker on our brain sheets now if we need it to be close by
  7. by   NicuGal
    We got dinged by the health department for not having an ID on the patient's body so we have to do it.
  8. by   zeus&lincoln
    We band each of our babies-- no matter the size with a comfy band and patient identifier. We also put a label on their name card and that is the band that we use for scanning. Each room has a COW. We bring the Meds in the patient room- scan the baby's band on their name card, scan the med and get a witness to input their passwords and Ids for Meds that require it. We even scan our pumps for rate changes and initiation of TPN. We will soon be scanning the med pump as well. Overall it works well, especially having a scanner and computer in each of the baby's rooms. I think scanning the baby is not feasible especially if they are sleeping or are in isolettes... That is why banding each baby and applying a band to their bedside card is best for us. We always check the band to ensure it is the correct baby, we just don't scan that band.
  9. by   rnkaytee
    We put a bar code on a Posey band so it's pretty soft even for tinier babes. We have a card with a barcode taped at the top of their isolette to scan (we just quietly lift the cover and scan).
  10. by   katierobin23
    Quote from NicuGal
    We got dinged by the health department for not having an ID on the patient's body so we have to do it.
    Sorry, I only meant to quote the part about putting a sticker on the computer
  11. by   2012rnnewbie
    We have a luggage style on the baby and the issolette it's facing out so we can have easy access. It's right next to the blood bank ID.
  12. by   prmc61
    we also band every baby with a posey soft band, and have a barcode label taped to our monitors. Works very well.
  13. by   bmsrn
    Our policy is that you HAVE to scan the patient. Every bedside has a computer and scanner. We have to scan the baby, then the med. Our ID bands are these little labels that look laminated. We usually get 2, so we wrap one around the ankle, then somehow loop the other one through it- we get creative. We do this because the barcode on the first band is so curved(around the ankle), it's usually doesn't scan. I personally like to make the 2nd one pretty long, so I can easily scan the barcode without disturbing a baby in an isolette. If it's a crib baby- almost always, their meds are timed around their feeding so they are already awake. If they aren't, I usually have pharmacy re-time them. The barcode on the ID band matches the barcode on every piece of paper in the chart so technically you can scan that, but if caught, it's probably a write up. If a baby has a HUGS tag, we just loop a ID band through the HUGS strap. Not every baby has a HUGS tag though.
  14. by   TiffyRN
    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!

close