Barcode medication administration work-arounds: a systematic review and implications for nurse executives

Area of Science:

• Healthcare Quality and Safety
• Nursing Informatics
• Patient Medication Management

Background:

• Safe medication administration is crucial for quality healthcare delivery.
• Barcode medication administration (BCMA) systems are implemented to minimize drug errors, reduce costs, and improve patient safety.
• Nurse-initiated work-arounds in BCMA processes can introduce unintended errors and compromise patient safety.

Purpose of the Study:

• To systematically review the existing literature on barcode medication administration (BCMA) systems and associated nurse work-arounds.
• To identify the impact of work-arounds on medication safety.
• To propose interventions for nurse executives to enhance medication safety within BCMA systems.

Main Methods:

• Systematic literature review methodology.
• Analysis of studies focusing on barcode medication administration systems.
• Examination of research detailing nurse work-arounds and their consequences.

Main Results:

• Work-arounds in BCMA processes are prevalent and can negate the intended safety benefits.
• Specific work-around behaviors can lead to medication administration errors.
• The literature highlights a gap in understanding and addressing the root causes of work-arounds.

Conclusions:

• Nurse work-arounds pose a significant threat to patient safety in barcode medication administration.
• Nurse executives must develop targeted interventions to mitigate work-arounds and reinforce safe medication practices.
• Further research is needed to understand and address the factors contributing to work-around behaviors in BCMA.