Implementing Bar Code Medication AdministrationBCMAUsing a Legacy System

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Implementing Bar Code Medication
Administration (BCMA) Using a Legacy System

• By Dawn Fell CIS, Project Manager/Analysis

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History

• Started 2004
• Early 2006 Decided to Develop in Health
  Evaluation through Logical Processing (HELP)
• Implemented in 2007- Opening of IMC

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Advantages of Legacy System

• Database Model Already Existed
• Agile Development Process/Release Schedule
• Nurses Already Familiar With Current e-MAR
  Charting.

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Required components

• PC at Bedside
• Scanner
• Barcode on the Medication
• Barcode on the Patient Identification Band

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Bedside PC

• Not All of the Facilities Were Identical
• If the Facility Used HELP
• If the PC Was Missing Where Did We Place it
• Close Proximity of the Patient

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Scanners

• Users Survey Not Users Preferences.
• 1D-2D Scanning Ability
• Wireless -vs- Wired
• Number of Scanners For Use on Units.

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Limitations of Scanners

• Room Size
• Responsiveness
• Learning Curve
• Ergonomics

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Medication Barcoded - Pharmacy Prep

• Partial Doses
• ½ tabs and ¼ tabs
• Partial liquids
• Tabs ( 1-2)
• Range Doses
• Insulin Orders

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Medication Barcoded - Pharmacy Prep

• Labels
• Zebra Label Printers
• Medi-Dose
• McKesson Pack Plus
• Non Medications
• Salt
• Tap Water
• Point of Care Glucose Scan

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Patient Identification

• Each Patient Had to Have Barcode on the ID Band
• Initially Tried to Find Cheaper Method
• NICU How to Ensure These Patients Have ID Bands
  With Barcodes
• Embosser Can Not Use 2D

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Nursing workflow

• Printed MAR vs e-MAR
• Prep at bedside
• Charting in real-time
• Pharmacy and Nursing communication

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Overriding with double check?????
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Today's Override Screen
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Training Tools

• Less Effective Tools
• Power Point with screen shots
• High-level flow charts

• Effective Tools
• Computers on wheels with scanners attached
• Sample Medications for hands on use
• Error Alert Tables w/ messages and meanings

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Training Lessons Learned

• More Training Scenarios/Test Cases
• Minimum Training Should be Mandated
• BEST PRACTICE Hands on Training by All End Users
  with Packaging From Real Medications

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Questions?????(Demonstration)