Barcoded Medication Administration (BCMA) refers to an inventory control system that utilizes barcodes to eliminate human errors in the distribution of prescription medication in health care facilities. The main purpose of BCMA is to ensure that patients are receiving the right medications at the right time. This is achieved by electronically validating and documenting patient medications ( Jelacic et al., 2015). The barcodes contain encoded information that allows medical professionals to the medication being administered to what was actually ordered for the patient. This helps in improving the quality of care by ensuring that patients receive the right medication at the right time. Basically, the BCMA system has been shown to be an effective tool for reducing medication errors in healthcare facilities. Besides, the system has been instrumental in managing inventory, improving billing efficiency, and saving time at the pharmacy and at the bedside. Therefore, it is important to improve bar coding compliance during the medication administration process in order to improve patient outcomes and the quality of care. Developing a quality improvement evaluation plan for increasing bar coding compliance can help in ensuring that patients receive the right medication at the right time.
Milestones
Collaborating with Pharmacy
A collaborative effort between nursing staffs and pharmacy has a significant potential to improve bar coding compliance ( McClead Jr et al., 2014). The collaboration allows nurses and pharmacists to proactively address any medical bar-coding issues that may reduce compliance rates. Basically, the effectiveness of bar-code medication administration is contingent upon compliance with the identified best practice protocols. As such, BCMA should be evaluated and improved continually utilizing a systematic process. This involves developing a process of ongoing rounding between nursing and pharmacy to monitor the compliance rate. Ongoing rounding between nursing and pharmacy allows for identification of bottlenecks which can then be addressed in a proactive manner. Additionally, the process can significantly help in streamlining the relationship between nursing and pharmacy with regards to improving bar coding compliance and enhancing the quality of care. Observing nurses throughout the medication administration process allows hospitals to identify faulty processes, evaluate changes, and recommend any relevant system changes. It is important to realize that using an observation-based medication error detection system can provide a reliable mechanism for identifying any medication errors. The collaboration between nursing and pharmacy improves the quality of the communication between the two critical areas.
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Updating Educational Materials and Policies
It is important to evaluate the integration of current evidence into existing BCMA educational materials and policies. As such, there is need for updating educational materials, policies, and guidelines to reflect process and expectation ( Jo, 2014) . This will ensure that the nursing and pharmacy staff learn and understand their new responsibilities, as well as what is expected of them. For instance, the nursing and pharmacy staff need to learn about the best way to coordinate in order to achieve the expected BCMA compliance rate of 95 percent consistently. Updating educational materials and policies ensures that both the nursing and pharmacy staff are able to integrate the changes into their daily routine effectively.
Implementing Ongoing Training
Medication administration processes are generally continuous and multidirectional. Therefore, there is need for continuous training in order to improve BCMA compliance. Ongoing training can help in decreasing medication errors by nurses ( Wisor, 2016) . It can positively influence patient care by promoting a culture of accountability within health care facilities. Ongoing training has the potential to increase employee retention, productivity, and job satisfaction. As such, ongoing training is a vital tool for implementing new processes and policies, particularly in the area of medication administration.
Medication Administration Safety Training
Generally, safe and accurate medication administration is an important nursing responsibility. However, it is a potentially challenging responsibility, particularly when there is inadequate training. This is because medication administration requires good and proactive decision making skills, along with informed clinical judgment ( Wisor, 2016) . Thus, medication administration training is necessary on a yearly basis. Regular training helps improve the quality of healthcare as it helps prevent adverse drug events.
Direct Supervision
Direct supervision of nursing and pharmacy staff to ensure compliance to BCMA policies and guidelines presents an effective quality improvement evaluation strategy. Healthcare leaders can identify and address issues that may impede successful BCMA compliance through supervision ( Lee et al., 2015). Direct supervision is effective in enforcing best practices among nurses and pharmacists. It also allows for effective and timely communications regarding bar coding issues that may impact the quality of care. Direct supervision is effective in preventing medication errors and near misses by nurses. Therefore, effective supervision programs should be emphasized ( Staggers et al., 2015). Direct supervision will begin immediately after training to ensure the best practices are implemented to the latter.
Reporting Nurses’ Scanning Rates
Reporting the scanning rate for each nurse can significantly improve BCMA compliance in healthcare settings. Generally, it is important to integrate scanning compliance goals with the chief nursing officer report card ( Staggers et al., 2015). This will provide important insights relating to the implementation of best practices in the bar coding medication administration process. Additionally, it will help in identifying the nurses that need more compliance training. The individual nurse scanning rates will be posted on weekly basis for transparency. Scanning reports will be carried out on a weekly basis for one month, after which they will be provided on a monthly basis.
References
Jelacic, S., Bowdle, A., Nair, B. G., Kusulos, D., Bower, L., & Togashi, K. (2015). A system for anesthesia drug administration using barcode technology: the Codonics Safe Label System and Smart Anesthesia Manager™. Anesthesia & Analgesia , 121 (2), 410-421.
Lee, B. C., Lee, S., Kwon, B. C., & Yi, J. S. (2015). What are the causes of noncompliance behaviors in bar code medication administration system processes?. International Journal of Human-Computer Interaction , 31 (4), 227-252.
Staggers, N., Iribarren, S., Guo, J. W., & Weir, C. (2015). Evaluation of a BCMA’s electronic medication administration record. Western journal of nursing research , 37 (7), 899-921.
Wisor, C. (2016). Increasing compliance of bar code medication administration in the emergency room.
Jo, J. (2014). Defining, Evaluating, and Improving the Process of Verifying Patient Identifiers.
McClead Jr, R. E., Catt, C., Davis, J. T., Morvay, S., Merandi, J., Lewe, D., ... & Collaborative, A. D. E. Q. (2014). An internal quality improvement collaborative significantly reduces hospital-wide medication error related adverse drug events. The Journal of pediatrics , 165 (6), 1222-1229.
