Med Admin using Bar Code Scanning

LuckyoneRN · Feb 27, 2008

I would also like to hear from others who use Epic and bar code scannning. We use Bridge for bar code scanning now and will switch to Epic in May for computerized charting/bar code med administration. Just like to know what to expect from those who use it now.

meownsmile, BSN, RN · Feb 27, 2008

We are supposed to be going to a system like that soon. It doesnt sound so good to me since we have a hard time trying to get meds in the pyxis so we can use them. We arent supposed to override the meds list for patients but find we have to frequently because they dont list the ones we actually need on that patients list. Another call to pharmacy and another fax with the order that should have been there in the first place.

So makes me wonder how it will go when we have to scan or check everything electronically.

AuntieRN · Feb 27, 2008

We use a system just like this. You have to scan the barcode on the pts id band then scan each med. I actually like it. It has prevented me from making a few med errors and it seems to save time because it charts the meds for you right then and there you dont need to remember to go back and chart anything.

At first it was a pain and time consuming but like anything else...once you get used to it its easy enough to use

elkpark · Feb 27, 2008

I started a position last Fall in a facility that is already scanning barcodes, and I love it! (My first experience with anything like this -- I had been out of direct client care for a long time). I don't know the proprietary names of our system (the hardware or software), but it seems v. "user-friendly" to me, and the really nice thing is that you really have to work at it to make a med error ...

In our system, the meds themselves are kept in a Pyxis, and a separate computer w/scanner is used for adminstration & charting. The computer is on a cart that can be rolled from room to room (although I'm in psych and we don't do that -- the clients come to the med room for meds). You scan each medication you're giving and scan the client's armband once (each time you're giving the client meds, but not for each med -- does that make sense?) The computer won't let you make a mistake -- you get a warning "beep" and a big red "X" on the screen if something's not right.

There is an override function for "problem" barcodes (on meds, and on armbands), although we are not supposed to use it unless absolutely necessary (kinda defeats the point of all the safety features built into the system :)), and there are a couple other features I really like. One is a button that allows you to immediately e-mail the pharmacy about that client's meds right from the computer, while you're giving meds. Another is the immediate availability of drug info -- there is a button at the bottom of the screen, and you just highlight a particular med and then hit that button and it opens up a window with a monograph with all the standard info for that medication -- right there while you're giving meds.

Although this is my first experience with a system like this and I have nothing to compare it to, I really like our system.

Dolce, RN · Feb 27, 2008

I use this system and it works great! You have to make it practice to scan the patient's wristband every time because there are ways to bypass the system without scanning the wristband. But, if the system is used correctly it is a huge error-reducer. The hospital I work for says that the incidence of med errors dropped 70% after implementing the system. All of the nurses that I work with love it--it is quick and essentially painless.

louisenpeter · Feb 27, 2008

We just started training for intelladot (Barcode Scanning). It is really a pain but hopefully it will become better and faster as we continue. We don't get our 9am meds out till almost noon. What a mess. :bugeyes:

EEG1 · Feb 27, 2008

My hospital uses Bedside Medication Verification (BMV) for med administration which also integrates with our computerized charting in Meditech. I cannot imagine using anything other than a barcode scanning system for med admin. I have personally experienced preventing med errors because of using this system. You must still keep in mind the "5 rights", but the barcode scanning is an extra way of ensuring patient safety. In our system, we scan each med, scan the pt's ID band, then scan our own name badge. Of course, there are some downfalls about using BMV (mostly just inconvenience...like having to take a COW with you when you want to give any meds). But the good things about BMV far outweigh the bad. I could go on and on about the good and bad of barcode scanning, but here are some highlights:

Good:

1. Charting is done right then and there when you are with the patient so you don't forget to do it later.

2. Our system allows us to pass meds then chart pt notes with just the click of a button.

3. The COWs we use have locked drawers that we can keep meds and supplies in.

4. If I have to give a blood pressure med, for example...I scan the med, then a box immediately pops up with the pt's most recently documented blood pressure. Another example would be giving heparin...the little pop up box shows me the pt's most recent PT/INR if available, etc.

5. When giving pain meds, a box pops up to fill out what the pt is rating his pain level 0-10, what type of pain scale he is using (numeric, FLACC), and where his pain is located. After giving the med, a reminder shows up on my status board next to the pt's name of what time I need to reassess the pt's pain level (exactly 1 hour after giving the pain med).

Bad:

1. The cows are large and difficult to push over doorways.

2. Sometimes pt's make comments about how they feel like they are an item from a grocery store being scanned.

3. If a pt has (what seems like) 1,000 meds to be scanned during one med pass, sometimes I feel like I spend more time looking at the computer screen than actually looking at the pt!

All barcode scanning systems are different, and these are just a few of the things that really stick out in my mind that are good and bad about our system. In general, I think barcode scanning systems promote patient safety and are a great piece of technology that should be used as often as possible.

Becca608 · Feb 27, 2008

I enjoy the system. Our clinical site uses them. Much easier to focus on actually giving the meds.

My only complaint about the whole computer system is that the MDs do not chart in the system. Do these folks take a class in decreasing their handwriting skills?

Dolce, RN · Feb 27, 2008

My only complaint about the whole computer system is that the MDs do not chart in the system. Do these folks take a class in decreasing their handwriting skills?

Yes, and they all pass with flying colors.

suzanne4, RN · Feb 27, 2008

I love it, love it, love it.

bookwormom · Feb 27, 2008

I have nursing students in a hospital which uses bar code scanning, and it has been very difficult for me to use this!!!

1) Wrist bands don't scan well, so staff uses the "charge card on the wall" to scan.

2) Some meds don't scan well or sometimes don't have a readable barcade, so one has to go to the "med list" on the hand held scanner.

3) The scanner has a screen that is hard to operate. The stylus is hard to aim on the up and down bar, and the onscreen popup keyboard is tiny and difficult to use. (I'm in the bifocal generation.)

4) The scanner pops up "med early" or "med late" unpredictably, sometimes when a med is one minute early or late. Then one has to enter some kind of explanation using the tiny onscreen keyboard.

5) I spend so long helping students use the scanner, that I can't have all of them giving meds on the same day, as I used to do.

6) I never got any real orientation to this new method. There isn't even a manual I can take home and study. The nurse manager helped me out a little, and the staff have been very nice, but mostly they say how hard the system is to use.

7) The scanners are bulky and a little grungy.

Could it be that the scanner system I'm using (don't know the name) is different from the one that everyone seems to like? Could our equipment be faulty? Or could it be a technology problem? We do use a pyxix system that is great.

I am not adverse to technology. My students have been using PDAs for years, and I am open to new things. It has been very interesting to read how satisfied some nurses are with this system.