Impact of the Bar Code Medication Administration (BCMA) System on Medication Administration Errors

Persistent Link:
http://hdl.handle.net/10150/195687
Title:
Impact of the Bar Code Medication Administration (BCMA) System on Medication Administration Errors
Author:
Doyle, Mary Davis
Issue Date:
2005
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Medication errors are the second most frequent cause of injury among all types of medical errors (Leape, et al., 1991). Of concern to nursing practice, medication administration errors (MAE) are second only to ordering errors (Bates, Cullen, et al., 1995). The introduction of information technology designed to promote safe medication practice, such as the Bar Code Medication Administration (BCMA) system, offers new opportunities for reducing MAE. BCMA was developed to improve patient safety, improve documentation of medication administration, decrease medication errors, and capture medication accountability data. The overall goal of this study was to evaluate the impact of BCMA on medication administration errors: wrong patient, medication, dose, time, and route. Rogers' (1995) theory, organizational diffusion of innovations, provided the study's framework.A descriptive comparative design examined incidence of MAEs before (Time 1) and after implementation (Time 2) of BCMA on eight units in one medical center. MAE incidence was calculated using MAE and patient-days data. Nurse adherence to BCMA usage procedure was assessed with a questionnaire created for the study.Findings indicated that total MAEs increased from Time 1 to Time 2, however, wrong patient and wrong dose errors decreased. There was a statistically significant (p < 0.05) increase in wrong route errors at Time 2. Comparing these findings with previous research demonstrated a diversity of methods, limiting conclusions. Nurse adherence findings indicated high overall adherence. However, completion of certain steps was hindered by software, equipment, or the work environment.Study findings were significant to nursing, informatics and patient safety research. Findings demonstrated the early state of BCMA research, added to knowledge about MAE detection methods, and brought a nursing perspective to information technology research on a process primarily within nursing purview. Implications for future research include improvement in MAE definitions and detection methods to support reliable data collection for research and quality improvement analysis. Also, sociotechnical theory recognizes health care as an interwoven, heterogeneous environment with complex roles and work practices, and may provide a more appropriate framework for evaluation of medication safety technology innovations than the linear model used in this study.
Type:
text; Electronic Dissertation
Keywords:
patient safety; medication errors; information technology
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Snyder, Rita
Committee Chair:
Snyder, Rita

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleImpact of the Bar Code Medication Administration (BCMA) System on Medication Administration Errorsen_US
dc.creatorDoyle, Mary Davisen_US
dc.contributor.authorDoyle, Mary Davisen_US
dc.date.issued2005en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractMedication errors are the second most frequent cause of injury among all types of medical errors (Leape, et al., 1991). Of concern to nursing practice, medication administration errors (MAE) are second only to ordering errors (Bates, Cullen, et al., 1995). The introduction of information technology designed to promote safe medication practice, such as the Bar Code Medication Administration (BCMA) system, offers new opportunities for reducing MAE. BCMA was developed to improve patient safety, improve documentation of medication administration, decrease medication errors, and capture medication accountability data. The overall goal of this study was to evaluate the impact of BCMA on medication administration errors: wrong patient, medication, dose, time, and route. Rogers' (1995) theory, organizational diffusion of innovations, provided the study's framework.A descriptive comparative design examined incidence of MAEs before (Time 1) and after implementation (Time 2) of BCMA on eight units in one medical center. MAE incidence was calculated using MAE and patient-days data. Nurse adherence to BCMA usage procedure was assessed with a questionnaire created for the study.Findings indicated that total MAEs increased from Time 1 to Time 2, however, wrong patient and wrong dose errors decreased. There was a statistically significant (p < 0.05) increase in wrong route errors at Time 2. Comparing these findings with previous research demonstrated a diversity of methods, limiting conclusions. Nurse adherence findings indicated high overall adherence. However, completion of certain steps was hindered by software, equipment, or the work environment.Study findings were significant to nursing, informatics and patient safety research. Findings demonstrated the early state of BCMA research, added to knowledge about MAE detection methods, and brought a nursing perspective to information technology research on a process primarily within nursing purview. Implications for future research include improvement in MAE definitions and detection methods to support reliable data collection for research and quality improvement analysis. Also, sociotechnical theory recognizes health care as an interwoven, heterogeneous environment with complex roles and work practices, and may provide a more appropriate framework for evaluation of medication safety technology innovations than the linear model used in this study.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectpatient safetyen_US
dc.subjectmedication errorsen_US
dc.subjectinformation technologyen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorSnyder, Ritaen_US
dc.contributor.chairSnyder, Ritaen_US
dc.contributor.committeememberEffken, Judithen_US
dc.contributor.committeememberLamb, Gerrien_US
dc.contributor.committeememberVerran, Joyceen_US
dc.identifier.proquest1093en_US
dc.identifier.oclc137353942en_US
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