Related Experiment Video
Updated: Jun 4, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician
Daniel F Miller1, Christopher R Fortier2, Kelli L Garrison3
1Daniel F Miller PharmD BCPS, at the time of the study, PGY-1 Health-System Pharmacy Administration Resident, Medical University of South Carolina, Charleston, SC; now, Clinical Pharmacy Manager, Department of Pharmacy Services John Randolph Medical Center, Hopewell, VA Daniel.Miller2@hcahealthcare.com.
The Annals of Pharmacotherapy
|February 3, 2011
Summary
Barcode medication administration (BCMA) technology can prevent errors, but workarounds by nurses and pharmacists limit its effectiveness. Continuous analysis and restructuring of workflows are essential for optimal safety outcomes.
Area of Science:
- Healthcare Informatics
- Patient Safety
- Medication Management
Background:
- Bar code medication administration (BCMA) technology is increasingly adopted to reduce medication errors.
- However, suboptimal implementation and use can lead to insufficient error prevention and introduce new risks.
Purpose of the Study:
- To assess the frequency of high-alert medication alerts generated by BCMA systems.
- To identify the types of alerts and clinician workarounds used with BCMA and electronic medication administration records (eMAR).
Main Methods:
- Retrospective analysis of medication scanning and override reports (2008).
- Evaluation of high-alert medication triggers, alert types, and override documentation.
- Observational study of nursing workarounds and analysis of pharmacy workflow issues impacting BCMA/eMAR.
Main Results:
- 17% of scanned medications triggered alerts, with 55% involving high-alert medications (e.g., insulin, hydromorphone).
- Clinician override reasons were documented in only 23% of cases.
- Nursing workarounds were frequent (median 3 per administration), including missed scans.
- Pharmacy workarounds posed risks of missed or duplicate doses and incorrect scheduling.
Conclusions:
- BCMA alerts have the potential to prevent high-alert medication errors.
- Nursing and pharmacy workarounds significantly hinder the realization of BCMA's safety benefits.
- Continuous analysis and optimization of clinical workflows are crucial to maximize BCMA's intended safety outcomes.
Related Concept Videos
01:26Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
01:24Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:19Pharmacovigilance
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
01:28Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
01:24Dosage Regimen: Individualization
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...