The intended quality improvement plan is to enhance the safety of the patients by reducing human errors in prescription medications at the hospital. This will be achieved by focusing on the utilization of the bar code scanning in the medication administration. The barcoded medication administration is an inventory control system that utilizes the bar codes to prevent human errors in the prescription of medications. The major objective of the BCMA is to ensure that the patients are getting the right medication at the right time by making electronic validation and documentation ( Seibert, 2016). While the organization has already implemented the bar code scanning, the compliance is still at 72% which is below the industry rate of 95%.
The mission of the health care organization is to advance the health of the community. The full implementation of the barcoded medication administration is in line with the mission of the organization. Because the goal of the project is to increase quality and patients safety, it aligns with the mission of enhancing the health of the community. Similarly, the vision of the organization is to be a recognized health care organization in terms of quality care. This is also in line with the project which aims at increasing the safety of the patients and increasing quality. The core values of excellence, teamwork, and safety of the patients as the guiding principles are also supported by the project ( Seibert, 2016). Through the implementation of the BCMA, it will eliminate errors in the medication and increase excellence as well as patients’ satisfaction.
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Overview of the Current Situation
The current use of the barcode scanning is at a suboptimal rate within the organization. Despite being implemented in 2011, the rate of compliance has lagged over the years thus increasing the risks of medication errors and reduced patients’ safety. The BCMA mainly consists of the barcode printer and a reader where each drug in the hospital is labeled with a unique barcode. After a patient has been prescribed for medication, it is then sent electronically to the pharmacist and then put into the computer system ( Kruer, Jarrell& Latif , 2014). This prevents errors in the medication and increases patients’ safety. Currently, the system is in place, but the rate of compliance is still low meaning that some medications are provided without doing a barcode scanning. This increases the risks of errors in the medication. The BCMA has five rights which are not being achieved. The right patient, given the right medication at the right time and in the right dose,is not currently being met.
Measures and Indicators
Current research shows that the rate of compliance in BCMA has been very low over the past few years in many health care organizations in the United States. Some nurses record as low as 20% compliance, a situation that increases the risks of medication errors. However, my health care organization though still operating below the industry rate has witnessed some improvement with a rise from 52% to 72% within five years ( Lindsay Bree Brown CRNA, 2014 ). The performance measures for this program are the increased patients’ satisfaction and reduced medication errors. The organization currently reports some few cases of medication errors that emerge as a result of failing to comply with the standards of BCMA. A reduction in the cases of medication errors and increased patients’ satisfaction will be an indication that the program has been fully implemented. Because the goal is to increase the patients’ safety and level of satisfaction, the performance inductors for the success of the project will be based on such factors as patients’ safety.
Data
A review of the electronic connections between the points of prescription to the point where the patient is given the drug can provide sufficient data of the state of the issue in the organization. Currently, most health care organizations in the United States are rapidly implementing BCMA at a rate of 27% in non-federal hospitals. In the whole federal sector, the hospitals have implemented the BCMA to help in the five rights during the medication administration ( Wisor, 2016 ). Previous research over the use of BCMA has shown that full compliance leads to a substantial reduction in medication errors. A recent study shows that full compliance with the BCMA can lead to almost an elimination of medication errors and increased patients’ safety. Research into the system shows that the current compliance rate is at 78% representing an increase from 55%. However, this is still low compared to the industry rate of 95% compliance. The future methods of data collection and analysis can be done through the review of various organization performance indicators such as a reduction in the number of medication errors.
Evidence-based Target
While the clinicians alone can help determine whether or not to administer medication to the patients, it also requires an application of the nursing process. The implementation of the BCMA can help in the realization of the five rights and promote patients safety. Current research has shown that when nurses maintain a compliance rate of 95%, the rate of medication errors can be greatly reduced ( Shanley, 2007 ). Maintaining a 95% compliance rate requires the provision of education and training to the nurses to help them adapt to the system and implement it fully. With effective training, the desired outcome of the project can be easily realized. The major intervention to help realize a 95% compliance is to provide continuous training of the nurses to ensure that they always apply the BCMA while administering the medication.
Donabedian Model
In the Donabedian model, the structure is the setting in which the care is delivered and include the attributes of resources such as human personnel and the organization structure. The process, on the other hand, refers to the means that are used to provide health care and can include services offered to the patients. The outcome is the impact of the care on the individual patients and the community as a whole. The quality of the structure is determined using a quality system such as the BCMA. The quality of the outcome is usually considered as the quality of the service offered which in the case of this program is the reduction in the number of medication errors.
Recommendations
The evidence-based practice to increase the effectiveness and compliance of the BCMA is to introduce educational programs for the hospital staff to help them learn and understand the best way to implement bar code scanning of the drugs. This has been proved as the best intervention to help increase the rate of compliance and reduce the number of medication errors that affect the quality of the care ( Wisor, 2016 ). The last research shows that the ongoing training and updating on the educational materials as well as the organizational policies and guidelines tend to increase the rate of compliance with the BCMA.
References
Kruer, R. M., Jarrell, A. S., & Latif, A. (2014). Reducing medication errors in critical care: a multimodal approach. Clinical pharmacology: advances and applications , 6 , 117.
Lindsay Bree Brown CRNA, M. S. N. (2014). Medication administration in the operating room: new standards and recommendations. AANA Journal , 82 (6), 465.
Seibert, H. H., Maddox, R. R., Flynn, E. A., & Williams, C. K. (2014). Effect of barcode technology with electronic medication administration record on medication accuracy rates. American Journal of Health-System Pharmacy , 71 (3), 209-218.
Shanley, C. (2007). Management of change for nurses: lessons from the discipline of organizational studies. Journal of nursing management , 15 (5), 538-546.
Wisor, C. (2016). Increasing compliance of bar code medication administration in the emergency room
