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Flaws in the barcoded technology used to reduce medication administration errors identified
Date:7/1/2008

PHILADELPHIA In the first study of its kind, researchers led by The University of Pennsylvania School of Medicine's Ross Koppel, Ph.D. studied how hospital nurses actually use bar-coded technology that matches the right patient with the right dose of the right medication. The surprising result is that the design and implementation of the technology, which is often relied upon as a "cure-all" for medication administration errors, is flawed, and can increase the probabilities of certain errors.

Equally surprising is that the urgencies of care and the ingenuity of nurses to cope with these shortcomings have the unintended consequences of creating other medication errors. These findings appear in the July/August issue of the Journal of the American Medical Informatics Association (JAMIA). The study also illustrates how adjustments to workflow and the technology can dramatically reduce the risk of these errors.

These barcode systems usually consist of handheld devices and computers that match machine-readable barcodes on patients and medications. If they match, and if they are consistent with the ordered medications, the medications are given. If not, usually a signal goes off telling the nurse of a discrepancy.

The study was conducted at 5 hospitals in the Midwest and on the East Coast, but not at the Hospital of the University of Pennsylvania (HUP) because it does not yet have medication barcoding. Penn's Ross Koppel, Ph.D. and his colleagues from other healthcare systems examined close to a half-million instances where nurses and other staff scanned patients and medications. The researchers found a remarkably high proportion of scans involved nurses overriding the technology with workarounds to compensate for difficulties with the barcode systems. These researchers found that nurses scanning the barcode on the medication or the patient's ID bracelet overrode the technology for 4.2% of patients charted and for 10.3% of
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Contact: Marc Kaplan
marc.kaplan@uphs.upenn.edu
215-662-2560
University of Pennsylvania School of Medicine
Source:Eurekalert

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