2 Contents Barcode Introduction Anatomy Hardware Model Software Model StandardsAdvantages & DisadvantagesCompetencies
3 What is BCMA? Electronic software application Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computerFirst developed 1995 VA Medical Center Topeka, KansasIntroduced nationwide in 2000(Wideman, Whittler, & Anderson, n.d.)
5 BCMA Basic Steps Physician order received Order faxed to Pharmacy Pharmacists edit and verify electronic orders into patient profilePharmacy dispenses ordered medications in Bar-Coded packagesNurse accesses BMCA software on computer via log onNurse scans unique patient bar-coded ID band
6 The Five Rights of Barcode Medication Administration: The right patientThe right medicationAt the right timeAt the right doseBy the right route
8 Barcode Scanning Device Light weight and comfortable hand held designBuilt in decoderEmits high intensity red aiming beamTrigger buttonThe handheld scanning device is constructed of hard durable plastic resembling those seen in the grocery store. The light weight and comfortable design makes it desirable for nurses to use at the bedside.The built in decoder helps to determine the right patient, right medication, right route, right time, and right dose.The high intensity red aiming beam is also similar to that in the store. This beam scans the patient, medication, and the nurses badge to prevent medication errors.The trigger button makes it easy to scan quickly and accurately.
10 Software Siemens Med Administration Check (MAC) Siemens Pharmacy INVISIONChart-AssistInterface with LCR and PYXIS Connect( Siemens 2005)Siemens medication administration software helps nurses at the bed side and prevents medication errors. The application is easy to use and is self explanatory allowing for user friendliness.Some of the software listed can be used in combination with MACThe goal of the future is to combine programs, improve safety, eliminate time consuming charting (paper charting) and allow for more time with the patient.The wave of the future is to allow for computerized charting and health information charting capabilities not only within hospitals, but with physicians offices as well.
11 Software MAC MAC is a nursing application Database collects, sorts, organizes, and stores informationDatabase allows nurse to easily retrieve select and aggregate dataOpen MAC application using login id and passwordSelect patient from databaseAll patients information is stored on databaseThe goal of MAC software is to eliminate medication errors at the bedsideDuring Report, she is able to check patient demographics, allergies, lab values, and other information right on the screen.Patient is selected by personal census, location census, patient inquiry, or by scanning patient id bracelet.
12 Figure 1. Pharmacy order-verifying software program screen displays Panel A: A sample patient profile displayed using the characteristic text-based terminal interface.Panel B: Medication entry finishing profile for an individual drug entry.
14 StandardsWhen multiple parties or companies are involved in the ID process, industry standards are usually establishedThe standard is not necessarily the same as the barcode symbologyBarcode standards define how to use the barcode symbology in a particular situationISBN is a standard for labeling booksPeriodicals that uses the EAN-13 symbology
15 Usability User friendly Easily learned Overall department satisfaction with useAccess information easilyInterface achieves particular goalsError tolerance
16 AdvantagesImproves medication administration flow with online work listChecks for five rights at the point of care with bar code technologyDrives online MAR documentation, charging, inventory controlUses proven point of care technology optionsIs designed for acute, ambulatory, long term care environment
17 Advantages Provides value added clinical and operation integration Can include assessment and process redesign consulting servicesCompatible with any automated drug dispensing device and drug wholesalerAssesses for pain by prompting a pain scale when administering analgesics
19 Disadvantages Not foolproof Bar codes mismatch with drug, dose, and patient at timesBar code sometimes function erroneouslyUnable to scan bar codes properly at timesDuplicate patient identification bar codes have been scanned for multiple patients
20 DisadvantagesCarrying several patients pre-scanned medications on one trayDisabling system alarms to avoid disturbing their patientsUnreadable bar codesEmergency SituationsTime consumingNurses are wearing multiple bar codes for multiple patients on their arms causing error.
21 Ethical/Legal Issues Potential problems in regards to HIPPA Leaving the computer in the hallway with patient name and identity exposedNurses not logging off the software applicationUnethical/ethical in regards to overridesNurses need to reexamine and be cautious when using override function. To use this option may be unethical if the wrong medication should be given and cause harm to the patient.
22 Competencies Clinicians have various technological backgrounds Users were accessible to staff every shift 24 hoursWorkshops are initiatedNeed successful completion of the courseTechnological backgrounds range from those with excellent computer skill to those with far lower computer literacy levels.
23 CompetenciesStaff representatives include inpatient pharmacist, ICU nurse, ward nurse, and a nursing instructorOngoing refresher courses offeredJob shadowingMultidisciplinary cross training techniques increase staff understanding and competency
24 High Beam infra-red light Name bracelet bar-coded
25 Conclusion Technology at work at the bedside Increasing safety Increasing continuity of careIncreasing satisfaction among staffIncreasing communicationSiemens Medication Administration Check is the wave of the future every hospital should look into this safety application to decrease medication errors.Patient safety is a priority and eliminating law suits and loss of money due to medication errors should also be a priority for all medical facilities.If the establishment could save money by eliminating medication errors monies could be used for increasing technologies within the facility.
26 Functions & Responsibilities of Informatics Nurses working with BMCA Incorporate theories, principles, and concepts from appropriate sciences and evidence based practiceIntegrate ergonomics and human-computer interaction principles appropriately and efficientlySystematically determine the social, legal, and ethical impact and play an active role in system improvement(McGonigle & Mastrian, 2009)
27 Conclusion Decreases medication errors Decreases law suits Regardless of some small disadvantages the application can be improved over timeOpens new windows and doors for communication and safetyAlthough there have been some disadvantages noted for this product the benefits far exceed the disadvantages.There is room for improvement so eventually the system may become flawlessRegardless of these disadvantages nurses are overall happy with this technology.
28 ReferencesTechnology for Long Term Care. (2008). Barcode Medication Administration. Retrieved February 15, 2009, from Technology for Long term Care Web site:McGonigle, D., & Mastrian, K. (Eds.). (2009). Nursing Informatics and the Foundation of Knowledge. Mississauga, Ontario Canada: Jones and Bartlett.