BCMA & Computers

RNPATL, DNP, RN · Jun 7, 2004

:) Does anyone out there use BCMA or use computers in their nursing?

Sorry about the lack of responses, but yes, I use BCMA as well as CPRS for clinical charting and medication administration. Overall, I like both systems and feel they add to a more comprehensive clinical record. However, each has their down falls.

night owl · Jul 4, 2004

I wish there was a website where you could go to for technical support! The BCMA is good if it's working properly. We just got one new med cart (we have three on my unit) which we are using on a trial basis. We haven't had it a week and already it's not working. It's a holiday weekend and no one is around to fix it. So for those 20 pts, the nurse has to manually enter her meds (some have up to 12 meds) in the LXE, the portable computer and now that's not working, so we have to use the back up system. By the time Tuesday rolls around, the med sheets will probably get lost somewhere with all the other papers that need to be filed so what's the point? And there goes your medication documentation in the garbage and me to jail god forbid I had to prove in a court of law I gave so and so meds. I can't stand it anymore! We've gone from BCMA version 1 to version 3, now new med carts that you can't even get the screen to turn on. Talk about a gross waste of funds! The DON says, "I don't care how you get your meds done, just make sure they're in the computer." The night supervisor once told the DON that the BCMA is really not appropriate for 60 pts per unit LTC facility. The DON told him, "Do you want to be demoted to staff nurse?" :angryfire When am I scheduled for that two day "Disturbed Behavior" class? August? Of what year??? :rotfl:

The CPRS is great and I love it. You can keep KEA though. They're always saying they're getting rid of KEA, but who knows when.

night owl · Jul 4, 2004

I wish there was a website where you could go to for technical support! The BCMA is good if it's working properly. We just got one new med cart (we have three on my unit) which we are using on a trial basis. We haven't had it a week and already it's not working. It's a holiday weekend and no one is around to fix it. So for those 20 pts, the nurse has to manually enter her meds (some have up to 12 meds) in the LXE, the portable computer and now that's not working, so we have to use the back up system. By the time Tuesday rolls around, the med sheets will probably get lost somewhere with all the other papers that need to be filed so what's the point? And there goes your medication documentation in the garbage and me to jail god forbid I had to prove in a court of law I gave so and so meds. I can't stand it anymore! We've gone from BCMA version 1 to version 3, now new med carts that you can't even get the screen to turn on. Talk about a gross waste of funds! The DON says, "I don't care how you get your meds done, just make sure they're in the computer." The night supervisor once told the DON that the BCMA is really not appropriate for 60 pts per unit LTC facility. The DON told him, "Do you want to be demoted to staff nurse?" :angryfire When am I scheduled for that two day "Disturbed Behavior" class? August? Of what year??? :rotfl:

The CPRS is great and I love it. You can keep KEA though. They're always saying they're getting rid of KEA, but who knows when.

night owl · Jul 4, 2004

And Pat, your av looks like Harry Potter with a mostache. :chuckle

night owl · Jul 4, 2004

And Pat, your av looks like Harry Potter with a mostache. :chuckle

RNPATL, DNP, RN · Jul 4, 2004

And Pat, your av looks like Harry Potter with a mostache. :chuckle

:roll I guess if I think about it, I am an older version of Harry Potter .... the av does look a lot like me which is kind of funny. :)

I certainly understand what you mean about the BCMA. The funny thing is that I have never been trained in what the back up for BCMA is for our hospital. If BCMA goes down, I am really not sure what to do, other than use Vista .... which would been a nightmare indeed. As far as administration is concerned, I think many of them have lost touch with the clinical setting. I can tell you that if they had to do a shift with faulty equipment and a med administration system that is full of problems, there would be some really fast fixes!

I work on a surgical floor and we have had one functioning vital sign monitor machine. I have begged and pleaded for workable equipment. The other day I received a post op aorto-by-iliac-fem-bypass back from surgery. Could not palpate any pedal pulses, so I went to get the doppler .... it was broken and there was not another one functioing in the hospital. This drives me nuts!

Anyway, thanks for letting me vent! :)

BadBird, BSN, RN · Aug 4, 2004

I am not loving BCMA, I find that it doesn't scan so we just punch in the numbers most of the time. I personally think that it slows down med passes, I do realize that it is designed to keep us from making errors but since it doesn't scan more than half the time it is no different that passing meds using a MAR.

RNPATL, DNP, RN · Aug 4, 2004

I am not loving BCMA, I find that it doesn't scan so we just punch in the numbers most of the time. I personally think that it slows down med passes, I do realize that it is designed to keep us from making errors but since it doesn't scan more than half the time it is no different that passing meds using a MAR.

I am not going to disagree with you at all. I think that if BCMA was used at it was intended, it would probably be ok. But, for us, we have 2 med carts and trying to do primary care with only two med carts is terrible. In addition, we really should be scanning the patient's arm band, but half the time we don't even have access to the med cart, so it is impossible to scan. We end up typing the patient's SS# in rather than scanning. As far as scanning the meds, well the concept is actually great, but half the time the scanners don't work or we can't get the scanner to the patient. So, with these challenges, you are right .... results in increased nurse frustration, missed meds and the big one ... meds that were given on time, but the scanner did not scan it, the nurse did not notice and the patient ends up being listed on the missed med report. Drives me nuts.

Maybe in the future they can correct these issues and then BCMA will be worth using.

VirginiaHeartNurse · Aug 19, 2004

i could go on for hours about my thoughts on the bcma and cprs systems, but i'll spare you all! :eek: i've worked for the va for a little over a year (been a nurse for 20 years, though) and i have never had such difficulty giving and charting meds as i do with these programs. i work in an icu so i never have more than 2 patients and i get so frustrated, i could scream. i can't imagine having to deal with the bcma for a whole ward of patients!!!

i am constantly amazed at the errors that show up. it seems like the program should pick up on things it doesn't. some examples are when the exact same med in the exact same dose is ordered twice on a patient (maybe once by an intern and then re-ordered by a resident), it will show up twice on the med sheet, many times right beside each other. i've seen ridiculous orders/doses show up (last week, a resident was trying to order a vasopressin drip on a patient. we usually make them 100 units vasopressin in 100 cc's ns. he ordered vasopressin 100 units iv now. i knew what he meant...but the bcma showed up with the order just as he had written it. hopefully, all who work in my unit would know not to give that as written, but the computer (or pharmacist!!) should spit the order back for a clarification/correction.

i realize that this system is supposed to be safer, not faster. i think the theory behind the whole system is great. i just think the way it is working now is awful and much more chance of error is present. we, too, also enter the numbers in manually many times. that is due to multiple reasons, some being the drug won't scan, we have to wait for pharmacy to enter an "available bag" number (even though we have a bag in our hands!), we have to wait for a change (such as time due) by the pharmacist and sometimes, we have the right med in our hand, scan it, and an "invalid med" error message pops up. :angryfire

it would be nice to be able to change the times online without having to call pharmacy to do so. it also amazes me that after 72 hours for narcotics, and after (can't remember the exact time) for antibiotics, the orders just fall off the screen. i can't tell you how many times i've had to remind the physician that the vanc or ancef or whatever it is they think their patient has been on dropped off the orders at midnight several nights ago and the patient hasn't gotten any since. or, i look for a pain med order and there aren't any...they expired and no one has renewed them. now, i know that if the doctors renewed them in a timely manner, this wouldn't happen, but we all know that that isn't always the case. the person who initially ordered the med may be gone on vacation or done with that rotation and no one takes the inititiave to re-order. so, we call for an order and hope that the 3 or 4 days that the patient didn't get the antibiotic won't make a difference. :chair: not that difficult, but it does take an extra 5 or 10 minutes and time is something most of us don't have enough of already while we're at work.

i'm sorry to complain so much but i get so frustrated with the whole thing because i feel like the patients aren't getting the full benefit of the technology.

anyway, i just always make sure i pay attention to all those things i learned a long time ago in nursing school (5 rights, good documentation-which i do on the flow sheet, pay attention to your patient) and i do the best i can with the computer. it will never be my priority....the patient will!

Toby's mum · Aug 19, 2004

Having read the comments regarding the computerized med system and all its complications/errors,I was wondering whether this experience is representative of Army hospitals too?

The reason I ask is because I'm considering joining the Army Nurse corp upon graduation. I was under the impression (perhaps mistaken) that the Army provides top-notch technology & equipment for its nurses & hospitals. Is this not necessarily the case? Thanks for your feedback.

explorer · Aug 28, 2004

i could go on for hours about my thoughts on the bcma and cprs systems, but i'll spare you all! i've worked for the va for a little over a year (been a nurse for 20 years, though) and i have never had such difficulty giving and charting meds as i do with these programs. i work in an icu so i never have more than 2 patients and i get so frustrated, i could scream. i can't imagine having to deal with the bcma for a whole ward of patients!!!
i am constantly amazed at the errors that show up. it seems like the program should pick up on things it doesn't. some examples are when the exact same med in the exact same dose is ordered twice on a patient (maybe once by an intern and then re-ordered by a resident), it will show up twice on the med sheet, many times right beside each other. i've seen ridiculous orders/doses show up (last week, a resident was trying to order a vasopressin drip on a patient. we usually make them 100 units vasopressin in 100 cc's ns. he ordered vasopressin 100 units iv now. i knew what he meant...but the bcma showed up with the order just as he had written it. hopefully, all who work in my unit would know not to give that as written, but the computer (or pharmacist!!) should spit the order back for a clarification/correction.
i realize that this system is supposed to be safer, not faster. i think the theory behind the whole system is great. i just think the way it is working now is awful and much more chance of error is present. we, too, also enter the numbers in manually many times. that is due to multiple reasons, some being the drug won't scan, we have to wait for pharmacy to enter an "available bag" number (even though we have a bag in our hands!), we have to wait for a change (such as time due) by the pharmacist and sometimes, we have the right med in our hand, scan it, and an "invalid med" error message pops up. :angryfire
it would be nice to be able to change the times online without having to call pharmacy to do so. it also amazes me that after 72 hours for narcotics, and after (can't remember the exact time) for antibiotics, the orders just fall off the screen. i can't tell you how many times i've had to remind the physician that the vanc or ancef or whatever it is they think their patient has been on dropped off the orders at midnight several nights ago and the patient hasn't gotten any since. or, i look for a pain med order and there aren't any...they expired and no one has renewed them. now, i know that if the doctors renewed them in a timely manner, this wouldn't happen, but we all know that that isn't always the case. the person who initially ordered the med may be gone on vacation or done with that rotation and no one takes the inititiave to re-order. so, we call for an order and hope that the 3 or 4 days that the patient didn't get the antibiotic won't make a difference. :chair: not that difficult, but it does take an extra 5 or 10 minutes and time is something most of us don't have enough of already while we're at work.
i'm sorry to complain so much but i get so frustrated with the whole thing because i feel like the patients aren't getting the full benefit of the technology.
anyway, i just always make sure i pay attention to all those things i learned a long time ago in nursing school (5 rights, good documentation-which i do on the flow sheet, pay attention to your patient) and i do the best i can with the computer. it will never be my priority....the patient will!

i deal with the bcma and a whole ward of patients on a daily basis. i keep track of a contigency computer also. believe me, it is an improvement over what we had.