1. Bar-Coded Medication Administration
Jill DiEmedio, RN

2. Objectives Describe Bar-Coded Medication Administration
Describe Hardware/Software
What is an information system?
What are the Adavantages/Disadvantages of BCMA
Describe the Legal/Ethical Issues

3. Objectives Describe Informatics Competencies
Describe Functions and Responsibilities
Describe a Summary of BCMA

4. What is Bar-Coded Medication Administration?
Abbreviated BCMA or BPOC
Barcode system
Prevents medication errors
5 rights of administration
(Sakowski, 2005)
Bar coded medication administration is also abbreviated BCMA, I will be referring to it as this throughout my presentation. It is also referred to as barcode point of care.
BCMA is a barcode system that combines a medication barcode, a patient id bracelet with a barcode..
The pharmacist inputs the information in the computer system labels the medication, The nurse then scans the medication and scans the patient id. If the medication does not match the patient, an alert will come up on the screen..
This system is designed to prevent medication errors in hospitals.
BCMA systems are designed to ensure right drug, right route, right patient in the right amount at the right time.

5. BCMA consists of…. Barcode reader
Portable Computer with a wireless connection
A computer server
Software
This system is set up on a wireless network using a scanner, portable computer, main server and software designed for medication administration.

6. BCMA Hardware Handheld scanning device Wireless mobile connection
Keyboard
Mobile computer/Cart 
Optional: Palm PDA 
(Siemens, 2005)
This is all the hardware that makes up the BCMA system, this system will also include software to make it complete.
The handheld scanning device is used to scan meds and patient identification bracelet.
The wireless connection is what allows us to receive info.
The keyboard is used to type in information i.e. username, password, error codes etc.
Mobile computer/cart is used to be able to transport the computer to patient beside for easier use and safety.

7. BCMA Hardware Hand held Scanner
The scanner is used to scan barcode on the patient’s wristband ID and then the nurse will scan the label on the medication to be dispensed to the patient.

8. Software Siemens Med Administration Check (MAC) Siemens Pharmacy
INVISION
Interface with LCR and PYXIS Connect
( Siemens, 2005)
This software is used in connection with the hardware to help prevent medication errors and eliminate paper charting of medications.
Siemens pharmacy is the system used to input medications by the pharmacist .
Invision is used in some facilities to admit, discharge, look up info on.
LCR and Pyxis are for dispensing medications (i.e. narcotics.) 8

9. BCMA Software Siemens Med Administration Check (MAC)
The Mac system is a nursing application used to try and eliminate medication errors at the bedside.
There is a patient census, location census and patient inquiry tabs on the screen which are used to access patient information. The nurse is able to check patient demographics, allergies, lab values, and other information right on the screen.
The information is put in the system by pharmacy then the nurse will verify orders.

10. Usability Axiom #1: Users must be an early and continuous focus
Axiom #2: The design process should be iterative
Axiom #3: Formal evaluation should take place
Siemens Med Administration Check meets Axiom #1 because this system is very user friendly and can be learned easily for nursing staff. I believe this delivers minimal effort and maximum efficiency for staff and patients. It allows for the nurses to spend more time with patients and less time trying to figure out medication errors, etc.
It also meets Axiom #2 because the system allows for errors so there for it is flexible when mistakes happen( Ex: you can override if your medication will not scan or the barcode is torn.)
Axiom #3 has also been meet because this system is transparent and is very easy to use. The medication dosage, route and frequency is all on the computer screen. Scan the med then scan the patient and a message will indicate that it is ok to give the med.

11. What is an information system?
Siemens med administration check
Proven point-of-care technology
Eliminate medication errors
( Siemens, 2005)
This system offers a network of hardware, software, and telecommunications.
The system is used to access Siemens Med Administration Check as well as any other clinical function needed at the bedside (e.g., vitals, I&O, assessments).
The primary function is to eliminate medication errors within a hospital setting.

12. Information Review Criteria
Type of information system (IS)
What healthcare professionals use the IS?
What functions does this IS enable the users to perform?
What configuration is used?
This is a clinical information system.
Staff nurses are the primary healthcare professionals using MAK system.
MAK enables staff nurses to performs such tasks as checking medication orders by the 5 rights, verifying orders and checking the patient’s lab values.
This is a point of care system.

13. Information Review Criteria
What data standards are used?
What nursing practice standards classification scheme is used?
Would you recommend this trend?
Joint Commission on Accreditation of Healthcare Organization’s patient safety and pain standards are the data standards used for this IS.
I researched and was unable to determine if any nursing practice standards or disease and procedure classification systems are used with this trend.
I would recommend this trend, I believe this is a huge assets in my nursing career. MAK system helps to prevent medication errors and allows for more time with patients.

14. Advantages Improve Patient Safety Reduce medication errors
Patient satisfaction
Nursing staff satisfaction
(Work, 2005)
Improving patient safety by using the 5 rights and through the reduction of medication administration errors.
A comparison of the medication administration error rates pre- and post-implementation shows that medication administration errors were reduced by an average of 82% for the five units that were studied
Nurses felt like their hospital was committed to a higher quality of care and the system would help in nursing recruitment
Patients felt the hospitals were committed to patient safety with the BCMA system

15. Disadvantages
Current number of proven software applications are limited
Relies heavily on being user-friendly and intuitive to the clinical end-user
Solution does not focus specifically on medication errors
(Newell, 2003)
There are few software applications available for BCMA.
These are just a few of the disadvantages of BCMA
Despite these disadvantages, it is apparent from a patient safety perspective, the benefit far outweighs the disadvantages

16. Legal/Ethical Issues Patient name and identity exposed
Nurses not logging off of computer system
Override function
(Perry, Shah, & Englebright, 2007).
Nurses may forget to log off the computer, leaving the screen up with patient name and information.
Some nurses may use the override function too often. Some examples include wrong patient or not correctly identifying meds.

17. Informatics Competencies
Using computers
Training
Operating MAK
Nurses need to be competent and comfortable with computers. Some examples include feeling comfortable with basic computer functions, such as keyboards, word documents etc
Nurses need to be fully trained in using the MAK system and super users available.
Nurses need to be able to navigate through MAK being comfortable using the program. Examples include clicking on tabs to see meds, labs etc.

18. Functions and Responsibilities
Training
Education
Monitor system
(Paoletti, 2007)
Nurses should be able to train incoming nurses on how to use the MAK system, ie: checking lab values, verifying orders, scanning meds etc.
The Informatics nurse should be able to provide ongoing training and continuing education for the staff, based on upgrades to the system.
The responsibilities included oversight and daily monitoring of the system, data analysis and integrity, and the establishment of useful reporting.

19. Summary Drugs labeled with unique bar codes
Patient has bar coded wrist band
Pharmacy places order in computer
RN verifies order
Uses 5 rights
Reduces medication errors
Patient safety
All meds are labeled with a unique bar code, that match what is entered in the computer by the pharmacist. The nurse will verify the order in the computer by checking the physicians order first. The medication is scanned and the nurses scan the patients id bracelet, once the computer confirms the 5 rights the nurse can proceed with administering the medication.
This whole process helps in reducing medication errors and improve patient safety.

20. References
Newell LM, Christensen D.,J Healthcare Inf Manag Fall;17(4):29-35 Perry, A.,
Paoletti, R.(2007) Bar-code Technology and Observation for Safer Drug Administration: Development of EMAR and BCMA System. American Journal of Health-System Pharmacy.64(5),
Sakowski J. (2005). Using a BCMA. American Journal of Health-System Pharmacy. 62(24),

21. References
Shah, M., & Englebright, J. (2007). Improving Safety with Barcode-enabled Medication Administration. Patient Safety & quality Healthcare
Siemens. (2005). Siemens Med Administration Check Technology that Helps Reduce Medication errors [Brochure]. Malvern, PA
Work M. (2005). Improving Medication Safety with a Wireless, Mobile Barcode System in a Community Hospital