Bar Code Scanning Meds - page 2
:uhoh3: At our hospital we are now instituting a bar code scanning system for meds that is linked to our computer system.We will have to get our meds out of the omnicell,suremed computer first anyway... Read More
May 12, '04Occupation: Nurse Educator Specialty: Nursing Education and Critical Care. ; From: US ; Joined: Mar '03; Posts: 2,112; Likes: 149Quote from pod184At the VA hospital where I work,barcode med administration has been around for 3 years. There were many complaints when it first came online, but that has subsided. Even my technologically challanged coworkers can do it. It certainly is not speedy, but it will cut down on errors.
Pod - same here, I work in a VA hospital and we have been using the BCMA for about 3 years. At first, everyone was challenged by the whole process, but, when the system is working well, it can be great. Unfortunately, nurses can find short cuts around the safety systems and I wonder if it really cuts the error rate when they do this. Overall I like bar code med. administration. It takes a little longer, but once you have the hang, not bad.
May 12, '04Joined: Nov '03; Posts: 16It's always hard when changes like this are made... but ultimately, they are intended to make things better - not worse. I'm a nurse working in IT now since 1996. I can say this: computers don't fix broken processes. You have to fix the process, and then use the computer to automate it to make it more efficient, or faster. I don't know why your system is requiring that manual entry... most of them don't, or don't have to. Maybe that's a process issue that needs to be looked at? It's worth bringing to the attention of the project team.
Changes like this are hard - it's hard to get used to new processes. Give yourself and the system time to adjust.
May 12, '04Joined: Oct '03; Posts: 501; Likes: 67I had a chance to use the bar code system and I liked it. The nurse showing me the machine, on the other, hand hated it. I think it was a matter of what you are use to. She thought it was more time consuming.
May 12, '04Occupation: Critical Care Joined: Aug '00; Posts: 2,629; Likes: 20The VA I work at uses the bar code medication administration and it is ok, it takes a while to get used to not having a MAR, it is slower but does cut down on medication errors if used correctly. The problem is that when several nurses are trying to pass meds at the same time and there are only so many computers to use you have to wait which slows your med pass down even more. It is the wave of the future and isn't going away so you just deal with it because you have to.
May 15, '04Occupation: LPN-RN student Joined: May '00; Posts: 75I still truly think that this will be tough to deal with.I work on an unrelenting floor that is fast paced.I average getting off from work an hour later as it is and I have certainly stayed alot longer than that.
I know that I will do the best I can but you know it seems like no matter what you do there is always more that you can't do.
And this is before the new system!
May 15, '04Occupation: RN Joined: Sep '03; Posts: 641; Likes: 26It is very time consuming and staff are getting out later because of it.
May 15, '04Occupation: CCU (coronary care); clinical research coordinator-neurology Joined: Jul '02; Posts: 1,088; Likes: 82We are going to the bar coding system later this year as well...I am not quite sure which system yet though. Hopefully it will work well.
Just out of curiosity...I wonder if there is a difference between the baby boomer generation and gen X and Y RNs and their like or dislike of going to computerized systems, etc. Any thoughts????
May 17, '04Joined: Jul '02; Posts: 111; Likes: 3We are in the process of implementing bar coding as we speak. Some of the more "memorable" med errors we have had recently would have been prevented by this system; wrong med, wrong pt...
The system we are using, Bridge, seems to be nurse friendly. Navigation between functions is simple.
I will try to answer a couple of the ? asked:
We increased our med admin time to 1 hour before to 1 hour after the scheduled admin time instead of 30 min before-30min after. Should cut down on the mad rush r/t limited computers.
Any order sent to pharmacy will show up on the nurses "order screen" for verification or clarification. Meds should not simply drop off. What is your facilities current practice of notification of automatic stop orders? This may not change...Chart checks and verification of orders will still take place but the prospective MAR will be on computer instead of paper.
Most of the complaints we have had during class are r/t pharmacy issues. Bar coding will not fix drugs not being available. 2 seperate issues. Thought needs to be given to override lists if you are using cabinets such as Omnicell or Pyxis.
One thing we found...there was much thought put into the BIG PICTURE, adding more computers, down time forms, how to document competency...The piece that we almost missed was the front line user issues:
If you are passing meds in a semi-private room, can you take both pts meds into the room with the computer and pass all while you are there? Yes you can but how do you keep them seperate..bed 1 in your right pocket/bed 2 in the left?? NO NO NO. We have asked the med nurses to come up with a system that will work for them. Trays, baskets, med trays...we have left it up to them to decide what is best. Don't wait for the suit and tie to tell you how to do this.
Most of our nurses are very optimistic about the sysytem. Yes there is some apprehension from most and a few are threatening to leave. Hate to see them go but probably due for a change.
May 17, '04Occupation: SICU, MICU Joined: Nov '03; Posts: 309; Likes: 22Quote from cannoliThis is scarry! Within the emar system that we use, even dc'd orders have to be acknowledged by a nurse. It will not drop off until it is. It sounds like a specific system error.Also, the pharmacy can discontinue a med, like an antibiotic, in error and the nurse would never know it was supposed to be given since it is no longer even listed in the system. This actually happened.
May 18, '04Occupation: RN Specialty: Acute Med, Pediatric Hematology-Oncology ; Joined: Apr '04; Posts: 115; Likes: 7the hospitals i've been to use this method for many meds. each nurse has her own barcode, the med has a barcode, and the pt. has a barcode. not only does it prevent med errors, but if for some reason an error does occur, it can be traced. no more passing the buck and blaming someone else. if u gave it, u r responsible for it.
May 25, '04Occupation: LPN-RN student Joined: May '00; Posts: 75We start the new system on June 1st so I will let you know how it goes.
May 25, '04Occupation: RN Joined: Apr '04; Posts: 441; Likes: 23Does this mean no more checking off MARs for the next day on the night shift? WoooooooHooooooooo!!! :hatparty:
One advantage to this I can see is if a nurse on a previous shift gave a med, but forgot to sign off on it, we'll be able to find out if it was given without having to track her down after she's left the hospital to find out, right?
Jun 7, '04Occupation: LPN-RN student Joined: May '00; Posts: 75Well we started the bar code scanning this week and anxiety was
running high all over the hospital.I don't think it helps when people are nasty with each other.
Pharmacy was going wacko.Right now we are all in a pit.
The system itself is not hard to use.A few cliches here and there but nothing difficult.The time factor involved because we are still using the omnicell to get the meds out first is a problem.And the cosigning of insulin on the computer is also time consuming.We have quite a few diabetics and give alot of insulin.
Well I must continue on.