Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing

Electronic Medication Administration with Barcoding (eMAR), also known as Barcode Medication Administration (BCMA), is a technology-driven process used in healthcare to ensure safe and accurate medication administration. It involves barcode scanning to match the right medication with the right patient at the right time. It reduces medication errors and enhances patient safety by verifying prescriptions, administering medications accurately, documenting administration details, and generating alerts for potential issues (Mulac et al., 2021). NURS FPX 4040 Assessment 3 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing.

Nurses are crucial in using eMAR, scanning patient wristbands and medication barcodes, recording administration details, reviewing alerts, and utilizing integrations with other healthcare systems. Through a systematic research approach using databases like PubMed and Google Scholar, I identified at least four peer-reviewed articles advocating the implementation of electronic medication administration with barcoding in nursing care. These articles provided evidence of how this technology can enhance safety standards and improve the quality of care in healthcare settings by employing keywords such as patient safety, electronic medication administration, and quality care.

Evidence of the Impact of Electronic Medication Administration on Patient Safety

This article focuses on the impact of BCMA and e-MAR on patient safety, quality of care, and the interdisciplinary team. These technologies have emerged as innovative solutions in response to collective data suggesting increased medication errors that compromise patient safety. An annotated literature review was conducted before their implementation to assess the impact of BCMA and e-MAR systems. This review involved analyzing various studies that elaborated on the advantages and disadvantages of the barcode medication administration system. 

NURS FPX 4040 Assessment 3 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing

One of the key benefits of BCMA and e-MAR systems is their ability to enhance patient safety. By utilizing barcode scanning technology, these systems ensure accurate medication administration by matching the right medication with the right patient at the right time. This helps to minimize the risk of errors, such as administering the wrong medication or incorrect dosage, thereby significantly reducing adverse drug events and improving overall patient outcomes. These technologies streamline medication management processes, improve documentation accuracy, and provide real-time alerts for potential drug interactions or allergies.

Furthermore, implementing BCMA and e-MAR systems positively affects the interdisciplinary team. These technologies enhance interdisciplinary teamwork among healthcare professionals by facilitating effective communication and collaboration. These systems integrate with other healthcare technologies, ensuring all team members can access accurate and up-to-date medication information. This promotes better coordination and reduces the potential for errors, contributing to a safer and more efficient medication administration process.

Impact of Electronic Medication Administration on Patient Safety

Implementation of Barcode Medication Administration (BCMA) technology on the incidence of medication administration errors in the hospital environment is the main focus of this study. The study began implementing the new technology in September 2008 in a staged rollout across multiple units. The study tracked adherence to BCMA technology and compared the rates of medication administration errors and adverse events before and after its implementation. It is important to note that only actual errors, not potential errors, were included in the analysis. The findings indicated a statistically significant reduction in reported medication administration errors by 43.5% after implementing Barcode Medication Administration (BCMA) technology.

Moreover, a remarkable reduction in incidental medication errors was lowered from 0.65 to 0.29 per person out of 100,000 overall persons. The outcome was a significant reduction of 55.4% in incidents of harm experienced by patients. Importantly, the study found that BCMA factors caused no errors classified at category E or higher. The findings of this study highlight the positive impact of consistent use of BCMA technology on patient safety. By implementing BCMA, the number of patients harmed by medication administration errors was significantly reduced. The study demonstrates that BCMA technology can effectively decrease medication errors and improve patient outcomes in the inpatient setting.

Organizational Factors Influencing Electronic Medication Administration

The study found several key factors that significantly impacted clinicians’ acceptance and utilization of the new system. Firstly, the implementation strategy was crucial in clinicians’ acceptance of the EMMS. The patient-centric approach, where each patient had one chart, allowed clinicians to learn and adapt to the system without interruptions or using hybrid charts. This approach maximized user behavior control and contributed to a smoother transition than implementation strategies like the Big Bang or the Phased approach.

NURS FPX 4040 Assessment 3 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing

Secondly, the support provided during the implementation phase was critical. The implementation team offered comprehensive support, including 24/7 availability, a dedicated phone line, and technical staff assistance. These efforts enhanced the participants’ belief in their ability to successfully use the EMMS, aligning with the Theory of Planned Behavior. Thirdly, the involvement of clinicians in the implementation team positively influenced user acceptance. Clinicians’ presence in the team engaged users and hospital executives, fostering a favorable attitude and social influence toward adopting the EMMS. Fourthly, the perceived benefits of the EMMS, such as access from anywhere, prompts and alerts, legibility of medication orders, and centralized information, contributed to a positive attitude towards system usage.

Lastly, organizational culture played a significant role. The hospital had previously embraced digital health initiatives, creating a culture conducive to adopting new technologies. Positive organizational culture was a social influence in facilitating users’ intention to adopt the system. However, participants also reported some negative perceptions and barriers. Insufficient computer units in clinical areas hindered routine tasks, highlighting the importance of adequate infrastructure during implementation. Participants also suggested more tailored scenario-based training to enhance their preparedness for the EMMS.

Implementation and Use of Electronic Medication Administration 

This article provides evidence that justifies implementing and using an EMMS in a healthcare setting. The study highlights several benefits associated with using EMMS, including a decrease in medication deviations, a reduction in medication reconciliation errors, and improvements in medication completeness during transitions of care. The study demonstrates that the integrated EMMS decreased medication deviation on admission and discharge from the hospital. This finding is consistent with previous studies showing reduced medication and reconciliation errors after implementing electronic systems. 

By utilizing the EMMS, clinicians could select medications from pre-filled dropdown lists, reducing the likelihood of medication omissions and mismatches. This functionality of the EMMS contributed to improved medication safety and accuracy during the prescribing process. The study found that using EMMS resulted in fewer omissions and mismatches between inpatient orders and discharge medications. This outcome aligns with previous research, which reported decreased medication omissions after implementing EMMS. This facilitates medication reconciliation by automatically transferring medication orders from the patient’s history list to the electronic discharge medications. This process eliminated the need for manual transcription, thereby reducing medication errors.

The study identified that the implementation of an EMMS improved medication completeness during the documentation of medication history on admission and discharge summaries. Clinicians mentioned that the EMMS helped them ensure information completeness, such as medication names, doses, and frequencies. This enhanced documentation accuracy can further prevent medication errors and improve patient safety during transitions of care.

Conclusion 

In conclusion, electronic medication administration systems offer significant advantages in healthcare settings. Implementing medication management systems has been shown to enhance the effectiveness of medication administration, minimize errors, and improve patient safety. Its features, like pre-filled order lists and automated reconciliation, minimize omissions and mismatches. Eliminating manual transcription, it enhances documentation accuracy. Seamless communication and information sharing improve medication safety during transitions of care. Overall, implementing this technology improves medication safety, efficiency, and documentation accuracy, enhancing the quality of patient care.

References 

Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030.

https://doi.org/10.1136/bmjqs-2021-013223 

Naidu, M., & Alicia, Y. L. Y. (2019). Impact of bar-code medication administration and electronic medication administration record system in clinical practice for an effective medication administration Process. Health, 11(05), 511–526.

https://doi.org/10.4236/health.2019.115044 

Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens, J. M. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342–351.

https://doi.org/10.1016/j.mayocpiqo.2018.09.001 

Vaghasiya, M. R., Penm, J., Kuan, K. K. Y., Gunja, N., Liu, Y., Kim, E. D., Petrina, N., & Poon, S. (2021). Implementation of an electronic medication management system in a large tertiary hospital: A case of qualitative inquiry. BMC Medical Informatics and Decision Making, 21(1).

https://doi.org/10.1186/s12911-021-01584-w 

Vaghasiya, M. R., Poon, S. K., Gunja, N., & Penm, J. (2023). The impact of an electronic medication management system on medication deviations on admission and discharge from hospital. International Journal of Environmental Research and Public Health, 20(3), 1879.

https://doi.org/10.3390/ijerph20031879