Barcode Meds/Patient

introspectiveRN · Apr 15, 2006

As a new grad I was offered two jobs: one facility had the traditional paper MAR and one had the eMAR.

I picked the place with eMAR.

I think that it is a wonderful system that's "got your back" when you are dispensing anywhere from 5 to 15 different meds per pt. it is not a substitute for knowledge and caution- just something to help us out.

The new wings at this hospital have the scanner & laptop with emar built in a small cabinet in the room, sort of like a little Murphy bed. You can document everything right there at the bedside if you wish or there are work spaces all over the wing so the you can (gasp!) SIT DOWN and document too :lol2: .

I love the wall system even better than the "COW" (computer on wheels). I guess like anything, some people's first response is to moan and groan about something new but...eMAR is only an improvement to me and well worth any minor inconveniences.

CarVsTree · Apr 15, 2006

I work at a hospital where the meds, accuchecks, and most of our supplies are barcoded. This works out good most of the time, except when you have something that won't scan. When this happens it can be a real pain.

When we have a med that won't scan, we can enter it manually. It's not a big deal at all. But our system has been in place for quite awhile.

CarVsTree · Apr 15, 2006

As good as this system seems to be, I have to wonder about its practicality in places like the ER where we often have patients who need meds RIGHT NOW who haven't even been registered into the system yet, or whom we don't have a CLUE who they are. Anyone have any experience with this kind of a system in the ER? Currently our accuchecks can be scanned with the patient armband and the barcode on our badges for our personal user ID - however the thing rarely actually scans anything, so we usually end up typing things in. I cna't imagine how inconvenient this system COULD be if it is moved to medications as well. Any thoughts?

Our ER doesn't use the barcode system and I don't know if they have plans to. ER is soooo different from the floors. I've never worked ER, but from what I've heard/seen with all of the protocols and needs to give meds quickly its just not practical. On the floors if we have an emergency we give the meds and save the container for barcoding after the incident. I think though in the ER that would be totally impractical.

CarVsTree · Apr 15, 2006

My hospital converted too to scanning meds and pts. It does catch stuff which is great but I don't like the physical set up. We have a lap top on a cart with the scanner connected on a wire to the lap top. Also there's a shelve on top of the keyboard, and keyboard slides out so you can put meds on top. But you have to push this cart around and if it's busy the cart is in constant use and the batteries go dead then you have no computer to pass meds for a while. This is so frustrating. Our scann also has an area to be placed on the R side of the lap top, which is what we were taught, but the wire then hangs down and gets caught in the R wheel of the cart and you'r trying to tug it out. Now there seem no real good way to place it anywhere. People then wrap it to the front and then it really gets twisted. It should have a retractable wire or wireless. The wheels are disgusting with filth and grime now. Not to mention there is barely ANY room in pts rooms and your dragging this cart. At times you get caught on something and must just be loaded with infectios material. I am really upset with isolation. We are required to use it even with these pts. We wipe the wire and computer down with disinfection wipes. We were suppose to get a portable one that one floor was trying out, but never got them. Not to mention when the computers go down you revert to paper and have to back track an ENTIRE chart.
Now I LOVE computers. But idealy in each room in the WALL should be this setup to bypass ALL of that. Cost is the huge factor but I think the best solution some of my coworkers have come up with. OR some type of handheld system.
The system is great just provide us the right setup.

Yikes! Sounds like your hospital chose the wrong system. Ours is a Cow as well but the scanner is wireless so you can just bring that in. I usually leave the COW at the door in case I have a problem with the scan not taking. For instance if I give 2 percocets on an order of 1-2. I must select 2 after scanning or it won't take. Having the COW close by so I can enter the 2 quickly and re-scan pt. is very helpful. Not having to drag it all the way in room is even more helpful.

WV_heart_RN · Apr 15, 2006

yes, we scan meds. just started it about six months ago. the premise is definitely a good one. the system our admin bought is terrible.. there have been so many errors in the way the system tells us to give meds. along with incorrect bar coding by the pharmacy techs.

i personally have had two close calls on giving meds that would have harmed a patient. had i not looked at the med and questioned why the patient was getting that med bad things could have happened.

we are in a continual battle with those who set up our computer mars and send up the meds to us. not only to get the right meds but to schedule them correctly and to get them to us on time.

when i have some who needs a cardizem drip they need it and the bolus now. not an hour or two down the road.

oh well.... i will quiet down now

introspectiveRN · Apr 15, 2006

yes, we scan meds. just started it about six months ago. the premise is definitely a good one. the system our admin bought is terrible.. there have been so many errors in the way the system tells us to give meds. along with incorrect bar coding by the pharmacy techs.
i personally have had two close calls on giving meds that would have harmed a patient. had i not looked at the med and questioned why the patient was getting that med bad things could have happened.
we are in a continual battle with those who set up our computer mars and send up the meds to us. not only to get the right meds but to schedule them correctly and to get them to us on time.
when i have some who needs a cardizem drip they need it and the bolus now. not an hour or two down the road.
oh well.... i will quiet down now

good grief!!! i would not like that :no: . i am sorry to hear that it such a pain. come on down to our new unit! it's bee-u-tee-full and they need nurses so badly.

seriously...

best of luck to you in dealing with that. yipes.

mysticalwaters1 · Apr 16, 2006

I love the wall system even better than the "COW" (computer on wheels). I guess like anything, some people's first response is to moan and groan about something new but...eMAR is only an improvement to me and well worth any minor inconveniences.

That's what I have the "COW." And a wall sounds so much better!!! OOOH I'd LOVE that!

mysticalwaters1 · Apr 16, 2006

Yikes! Sounds like your hospital chose the wrong system. Ours is a Cow as well but the scanner is wireless so you can just bring that in. I usually leave the COW at the door in case I have a problem with the scan not taking. For instance if I give 2 percocets on an order of 1-2. I must select 2 after scanning or it won't take. Having the COW close by so I can enter the 2 quickly and re-scan pt. is very helpful. Not having to drag it all the way in room is even more helpful.

yea even THAT would totally be better!

mysticalwaters1 · Apr 16, 2006

yes, we scan meds. just started it about six months ago. the premise is definitely a good one. the system our admin bought is terrible.. there have been so many errors in the way the system tells us to give meds. along with incorrect bar coding by the pharmacy techs.
i personally have had two close calls on giving meds that would have harmed a patient. had i not looked at the med and questioned why the patient was getting that med bad things could have happened.
we are in a continual battle with those who set up our computer mars and send up the meds to us. not only to get the right meds but to schedule them correctly and to get them to us on time.
when i have some who needs a cardizem drip they need it and the bolus now. not an hour or two down the road.
oh well.... i will quiet down now

i have noticed with our system stuff like this too. we have a scanner that accepts orders where pharmacy recieves it and puts it into the computer system. i find duplicate orders all the time and am on the phone back and forth to correct it. one time i had an order for lasix 40 mg every other day and 20 mg on the oposite days. which i never heard of it like that but looked at the original order and that is what it was. i had this pt and noticed lasix and i didn't remember giving it before so i looked and saw 40mg already given in the morning. anyway somehow there was an extra lasix every other day for 1700. along with that was the 40 of lasix every other day with the 20 in the morning but an extra 40 at 1700 every other day. ok well that sounds confusing anyway but i've seen it on other things and my point is i remembered this pt the previous day and looked into it. what if it was someone who never had the pt you'd have no idea and give the med. so i see that opening. as far as the computer that contains the meds, i have had instances where wrong medication was in the wrong slot but not too much. but at least you look before you give it so you can catch that and proabably easy enough to do. the computer mar at least my system that extra dosing does scare me though. it does help you get the right med, dose, and pt. and i love computers but finding the right system i don't know. also for some reason our computer has lots of windows to go in and out of to get to everything. infact if you don't go in a certain order it will kick you out too. i sound like i hate computerized system, i enjoy it but i want it right!