bar coding for med administration

chenoaspirit, ASN, RN · May 5, 2008

I would like to know that too. My hospital is going to start the bar-coding system. I would think it would significantly decrease the risks of med errors, but may take more time to administer meds. And if pharmacy hasnt entered a medication into the system, then what. Especially new orders.

aeauooo · May 5, 2008

We use bar coding where I work. It wouldn't be so bad if the bar codes on the packages scanned consistently. Sometimes I'll spend 5 minutes trying to scan a single med before I can give it. If I give it without scanning it I get a note in my mailbox warning me that disciplinary action will be taken if I don't improve.

Some of the bar codes are very small and difficult to focus the laser on, other packages are wrinkled and difficult to scan, or the pharmacy attaches a label to a bottle so that the bar code is curved and won't scan.

In other words, I'm sure it does prevent medication errors, but until the system is improved so that I don't have to waste time trying to scan my meds, it's a pain in my butt.

TRINI_RN · May 5, 2008

Bar coding is used on the floor I'm an extern on. Overall I really like it, haven't had the same problems as the previous poster with the inconsistent scanning. One thing I have noticed though is that on rare occasions we've scanned the pt and the med and saved and exited and then later it doesn't show as given on the EMAR. Its only happened twice I think, but that is a huge discrepancy.

Ruffles 1 · May 5, 2008

We use the bar code scanning of meds. where I work and you have to watch the dosage to be given, which means you have to manaully change the dose to 1/2 tab or 0.5mg in 2 places. I have also had problems with scanning the packages on meds. or even IV fluids. It is very time consuming but probably has cut back on medication errors.

elkpark · May 5, 2008

I've been working for six months at a facility with barcode med administration (my first experience with this), and I love it. The system makes it almost impossible to make a med error. Our system prompts us if a dosage is different from what is dispensed (e.g., you need to only give half a tablet).

Yes, the scanner is somewhat "fussy" about reading some barcodes (a few particular medications, and curved bottles) but, overall, I don't think it takes me much more time than the old way, and I'm happy to sacrifice a little time to have a system where you have to actually work at it to make an error ... :)

jjjoy, LPN · May 5, 2008

So much depends on the system and how it is managed. The actual software program makes a difference because some are easier to use and some have more inherent problems. Thus, one system may have problems reading certain bar codes and another system doesn't have that problem. How the system is managed also makes a big difference. Who is responsible for updating new bar codes? How do new orders get into the system (and is it timely)? Who puts the bar codes on (can they avoid putting them places where it makes scanning difficult)? What is the supply storage and transfer arrangements (is it possible to avoid wrinking bar codes)? So there's no absolute verdict on whether or not bar coding makes it easier or more difficult for nurses.

I think the OP's question about what challenges have been faced and how have they been addressed is most useful, though each facility's challenges will be somewhat unique.

catlynLPN · May 5, 2008

We use barcoding where I work. It's a PITA.

The pharmacy doesn't barcode all of the medications, which they are supposed to, so we end up having to print barcodes.

I have run across barcodes that won't scan at all, some that scan but tell me the med has been dc'd and I know it hasn't so I have to print a barcode for it, some barcodes are assigned to another person {pharmacy's fault}, and just on and on.

Since we are more along the line of a LTC, we have monthly changeouts of all the regular blister packed meds, so all that has to be checked in, scanned, barcoded, and separated into the scheduled times.

It's not a one-night job by any means, and needs at least 3 nurses to get it all done, if it gets done in a decent time frame.

wearingmanyhats, RN · May 5, 2008

I have worked with a barcoded med pass for about 5 yrs now. I LOVE IT!!! It can be fussy as far as scanning goes, but that only makes me double check what is in the pack vs what I am supposed to give.

I think it has ABSOLUTELY cut down on med errors -- UNLESS you try to bypass the system (which I have seen some nurses try to do.....)

Penelope_Pitstop, BSN, RN · May 6, 2008

i think the biggest "difficult to scan" culprit is iv fluids! i had trouble with this using both the bridge and cerner emar systems. it helps to lay the bag on a counter or put paper behind it, but it is still tricky.

i've also experienced problems scanning the patient. when this happened, we needed to send for a new one from admitting, which is a serious pain (because you know it happened when you had a million other things to do!)

overall, i prefer the cerner to bridge. cerner seems to have more of a brain, but be warned, those who rely on electronic mars and barcoding systems..."never trust something that can think for itself if you can't see where it keeps its brains." not only does it apply to tom riddle's diary, but also computers. :throcomp:

jess