By Luwana Walton, RN – Gayco Consultant Nurse
A medication error is “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is controlled by the healthcare professional.” according to the National Coordinating Council for Medication Error Reporting and Prevention.
The FDA put rules requiring barcodes on certain drug and biological product labels. Barcodes allow healthcare professionals to use barcode scanning equipment to verify that the right drug, in the right dose and right route of administration, is being given to the right patient at the right time. This system is intended to help reduce the number of medication errors that occur in healthcare settings. Studies show scanned medications triggered an error alert, of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages.
Failure to use barcode scanning
One of the repeated comments noticed during a review of the error reports was that an available point-of-care barcode scanning system had not been utilized before administering an incorrect medication. Many nebulizer medications and solutions come in multipacks and do not have barcodes on the individual unit-of-use vials (although barcodes may be on the outer carton or inner foil pouch). However, the comments on some error reports suggest that, even in the presence of a pharmacy-applied barcode, nurses bypass the scanning process before administering medications. Several reports noted that the administration was never documented on the eMAR when the barcode scanning process had been bypassed. In several instances, this led to a duplicate dose administered by a nurse who did not know that the medication had already been administered.
Scanning medication barcodes on medication packaging ensures getting the right medication to the right resident with the right dose at the right time, using the right route, and following up with the right documentation, which prevents medication errors.
With most eMAR systems, a medication scan report can be run to check for % of scanning during their facility medication pass. Facilities that utilize the barcode scanning process result in fewer medication errors improving the quality and safety of medication administration.