Hospitals must improve medication adherence system use to protect patients, report says
- Many hospitals are struggling to properly use medical technology designed to prevent bedside medication errors, according to a Leapfrog Group report published Thursday.
- Bar code medication administration (BCMA) systems are used with an electronic medication administration record at 98.7% of the hospitals surveyed, but fewer than 35% meet the four standards for proper deployment set by Leapfrog.
- This represents an improvement from the 30.2% of hospitals that fully met the standard in 2016, according to the nonprofit.
Proper administration of medication is vital for providers to avoid patient harm. A 2016 study estimated that preventable medication errors impact more than 7 million patients annually across all care settings. A separate 2016 study noted that efficacy data over BCMA systems are lacking. It found that although there was not a significant decrease in administration errors, the BCMA system did result in a significant decrease in harm to patients.
BCMA systems aim to ensure that patients receive the correct medication at the appropriate dose and time by having the clinician scan a barcode on a patient’s wristband before providing treatment.
In addition, the system communicates with EHRs to check for relevant patient-specific allergies, harmful drug interactions and vital signs.
Leapfrog’s standard contains four measures aimed at measuring appropriate BCMA use:
- BCMA systems should be linked to an EHR in 100% of a hospital’s medical, labor and delivery, surgical and intensive care units.
- Both medication and wristband bar codes should be scanned in at least 95% of bedside administrations.
- BCMA system decision support should contain a vital sign, patient-specific allergy, backup nurse support, wrong time, wrong dose, wrong patient and wrong medication check.
- Adherence to best practices including: a formal committee established to oversee BCMA use, backup systems for hardware failures, a help desk established for real-time issue response, real-time observation of staff who use BCMA systems and engagement with nursing leadership regarding BCMA use.
Frequent omissions by hospitals include a lack of a vital sign check (78%) and patient-specific allergy check (51.1%). In addition, 42% of hospitals surveyed failed to scan medication and wristband bar codes at least 95% of the time.
“It is encouraging to see almost all hospitals have bar coding in place,” Leapfrog CEO Leah Binder said in a statement. “But it only protects patients to the extent it’s used correctly. Unfortunately, hospitals have work to do to maximize the potential of this important technology."
The report surveyed about 2,000 adult general acute care and free-standing pediatric hospitals in the U.S., two-thirds of inpatient beds.
“A considerable number of hospitals still do not report on BCMA usage. Additional transparency from these facilities is critical to making true patient safety gains,” according to the report.
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