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Association between workarounds and medication administration errors in bar-code-assisted medication administration
Willem van der Veen1, Patricia M L A van den Bemt2, Hans Wouters1
1Faculty of Science and Engineering, Department of PharmacoTherapy, PharmacoEpidemiology and PharmaEconomics, University of Groningen, Groningen, the Netherlands.
Journal of the American Medical Informatics Association : JAMIA
|October 13, 2017
Summary
Workarounds during barcode-assisted medication administration (BCMA) are common and significantly increase medication administration errors. Hospitals need further evaluation of BCMA implementation to improve patient safety.
Area of Science:
- Healthcare Quality and Safety
- Clinical Pharmacy
- Health Informatics
Background:
- Barcode-assisted medication administration (BCMA) is implemented to enhance patient safety.
- Workarounds and medication administration errors (MAEs) can compromise BCMA effectiveness.
- Understanding the relationship between workarounds and MAEs is crucial for optimizing medication safety.
Purpose of the Study:
- To investigate the association between workarounds and MAEs in hospitals utilizing BCMA.
- To determine the frequency and types of workarounds and MAEs encountered during BCMA use.
Main Methods:
- A prospective observational study was conducted in Dutch hospitals.
- Direct observation of medication administrations using BCMA was performed.
- Statistical analyses included univariate and multivariate multilevel logistic regression and descriptive statistics.
Main Results:
- Workarounds were significantly associated with MAEs (aOR 3.06).
- Workarounds occurred in 66% of medication administrations.
- Common workarounds included not scanning, issues with wristbands, and ignoring alerts. MAEs were primarily omissions (78%).
Conclusions:
- Workarounds are a significant factor contributing to MAEs in BCMA systems.
- Post-implementation evaluation of BCMA is essential to realize its intended safety benefits.
- Addressing workarounds is critical for improving medication safety in healthcare settings.
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