Preventing Workarounds in the BPOC Process – Part 1. Introduction

Barcoded Medication Administration  (BCMA) or Barcoding at the Point of Care (BPOC) Technologies are effective at stopping medication errors from reaching the patient, when they are used effectively.   The best hospitals have reached medication scanning compliance rates of 98% at the bedside and have obsessively sought out and stopped work arounds to the technology that limit its effectiveness.

A quick google search of “workarounds to bedside medication” will bring up the Kopel, et. al, paper and a number of other great scholarly articles on some of the unintended consequences of BCMA systems.   All should be required reading, but what are some things you can actually implement to avoid workarounds to BCMA technologies?

In the next few posts  I will share some strategies you can utilize to minimize some of the most common workarounds at the bedside.

The cornerstone of the BCMA process is the Patient Armband.  Patient armbands must be readily scanable by nurses at the patient bedside.  To make this happen, use a robust thermal transfer material, print 2D Barcodes around the entire printable surface area of the armband, use a LARGE human readable font for key patient identifiers, ie Age, Name and Date of Birth.

The patient should be scanned at the beginning of the medication process, not the end.  In-situ observation of behaviors have shown the increased likelihood of medications being scanned away from the patient bedside, when they are scanned before the patient identifying armband.

Beware “proxy” barcodes. If there are other bar code labels in your environment that can be scanned to identify the patient to the Medication Administration System, they will at some point be utilized to identify a patient to the system.

To be continued…..

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