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Barcode Technology Flaws Put Some Patients at Risk
Date:7/3/2008

Nurses forced to use 'workarounds' to ensure medication errors are kept to minimum, study says

THURSDAY, July 3 (HealthDay News) -- Flaws in the design and implementation of barcode systems designed to match hospital patients with the right dose of the right medication can increase the risk of certain medication errors, according to a study that looked at the use of the system in five U.S. hospitals.

The first-of-its-kind study looked at almost half a million instances where nurses and other staff scanned patients and medications. In a remarkably high percentage of instances, nurses overrode the technology in order to compensate for awkward or inconvenient aspects of the barcode systems. Nurses scanning the barcode on the medication or the patient's ID bracelet overrode the system for 4.2 percent of patients charted and 10.3 percent of medications charted.

The researchers identified 31 causes of system problems that prompted "workarounds" by nurses. These included: unreadable medication barcodes (crinkled, smudged, torn, missing, covered by another label); malfunctioning scanners; unreadable or missing patient ID wristbands; non-barcoded medications; medications in distant refrigerators; lost wireless connectivity; problems with patients in contact isolation, and emergencies.

Workarounds used by nurses included: affixing extra copies of patient ID barcodes on desks, scanning machines, clipboards, supply rooms, and doorjambs, as well as carrying several pre-scanned patient medications on one tray.

"It's not that staff are lazy or careless, it's that the system does not work as well as it should. If the refrigerated medication is two floors and a long hallway away, you're not going to wheel your 87-year-old patient to the fridge. You make a copy of her barcode. And while you do that, you help another two patients who also need refrigerated medications," study leader Ross Koppel, of the University of Pen
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