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Related Experiment Videos

Improving patient safety by identifying side effects from introducing bar coding in medication administration.

Emily S Patterson1, Richard I Cook, Marta L Render

  • 1Ohio State University, Columbus, Ohio, USA. patterson.150@osu.edu

Journal of the American Medical Informatics Association : JAMIA
|September 12, 2002
PubMed
Summary

Implementing bar code medication administration (BCMA) in healthcare introduced unintended negative side effects. These changes in nurse-technology interactions may create new risks for adverse drug events (ADEs).

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Area of Science:

  • Healthcare technology
  • Sociotechnical systems
  • Patient safety

Background:

  • Introduction of new technology in complex systems can yield unforeseen consequences.
  • Bar code medication administration (BCMA) was implemented to reduce adverse drug events (ADEs).
  • This study examines the side effects of BCMA implementation in healthcare.

Purpose of the Study:

  • To identify potential accidents by examining side effects of BCMA implementation.
  • To understand the technical, social, and organizational impacts of BCMA.

Main Methods:

  • A cross-sectional observational study comparing medication passes before and after BCMA implementation.
  • Ethnographic observations of nurse-BCMA interactions were analyzed using process tracing.
  • Analysis involved five conceptual frameworks to classify observed interactions.

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Main Results:

  • Sixty-seven nurse-BCMA interactions were observed and categorized.
  • Five negative side effects were identified: nurse confusion with automated medication removal, degraded nurse-physician coordination, nurses dropping tasks, increased prioritization of monitored tasks, and reduced ability to deviate from routine.

Conclusions:

  • Identified side effects may introduce new pathways to ADEs.
  • Recommendations include design revisions, policy modifications, and targeted training.
  • Minimizing these side effects is crucial to prevent adverse patient outcomes.