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Raising the barcode: improving medication safety behaviours through a behavioural science-informed feedback
Kate Grailey1, Alix Brazier2, Bryony Dean Franklin3,4
1Centre for Health Policy, Imperial College London Institute of Global Health Innovation, London, UK k.grailey18@imperial.ac.uk.
BMJ Quality & Safety
|June 20, 2024
Summary
Implementing a feedback intervention significantly boosted barcode medication administration (BCMA) scanning rates. This patient safety technology saw a 23.1 percentage point increase, demonstrating the effectiveness of behavioral science in healthcare settings.
Area of Science:
- Health Informatics
- Behavioral Science
- Patient Safety
Background:
- Barcode medication administration (BCMA) technology enhances patient safety by verifying the right drug, dose, and patient.
- Low scanning rates (0-20%) were observed in a London NHS trust, indicating challenges in BCMA adoption.
- Nursing staff workflow adaptation is crucial for successful BCMA implementation.
Purpose of the Study:
- To increase patient safety behaviors, specifically medication scanning rates, using a feedback intervention.
- To codesign an intervention with nurses, addressing known barriers to BCMA use.
- To evaluate the impact of a behavioral science-informed feedback intervention on BCMA scanning rates.
Main Methods:
- A quasi-experimental design was used with five intervention wards and 14 control wards over 18 weeks.
- A bespoke feedback intervention incorporating gamification, the messenger effect, and framing was delivered weekly.
- Linear difference-in-difference analysis assessed the intervention's impact on scan rates.
Main Results:
- Medication scanning rates increased by 23.1 percentage points on intervention wards (15.0% to 38.1%) compared to controls (p<0.001).
- The most significant impact occurred within the first six weeks, with a 26.3 percentage point increase (p<0.001), followed by a plateau.
- Clinical specialty and ward bed count did not significantly influence the intervention's effectiveness.
Conclusions:
- A feedback intervention, codesigned with end-users and grounded in behavioral science, significantly improves BCMA scanning adoption.
- This approach offers a scalable strategy to enhance medication safety in healthcare settings.
- Addressing workflow and user behavior is key to maximizing the benefits of health technologies like BCMA.
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