Breaking down the barriers to effective bar-code medication administration

According to the Commonwealth Fund and the Organisation for Economic Co-operation and Development (OECD), the health care system in the United States continues to rank the highest in health spending, has the highest rates of avoidable deaths, and rates of infant and maternal deaths compared to other high-income countries. These countries include Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom. Despite the high health care spending, the frequency of annual physician visitations among Americans is lower than in most countries. Unfortunately, the U.S. also has the lowest life expectancy at birth, the lowest rates of practicing physicians, and the lowest rates of hospital beds per 1,000 population. With Americans having an average life expectancy of 77 years, which is three years less compared to other high-income countries. Life expectancy at birth is a health status indicator that can be influenced by living standards, lifestyle, education, and access to quality health care services. There are many reasons why the United States continues to have these issues relating to poor health outcomes, from the social determinants of health to the lack of universal insurance coverage. Change does take time, but if we can reduce the rates of avoidable deaths and health care spending with an existing solution, then why wouldn’t we?

As mentioned, one of the factors that can increase life expectancy is high-quality care defined as safe, timely, efficient, effective, equitable, and person-centered. The most common preventable medical harm and error are medication errors. This issue decreases the quality of care, trust, and patient satisfaction, which can exacerbate the current issues that already exist in the U.S. health care system. According to the World Health Organization (WHO), “globally, half of all preventable harm in medical care is medication related, a quarter of which is severe or life-threatening,” the annual cost is approximately $42 billion USD worldwide. In the United States, 7,000 to 9,000 individuals die yearly due to medication administration errors. More than 7 million individuals are being treated for medication-associated errors with costs exceeding $40 billion each year.

Information technology has improved patient safety, including bar-code medication administration (BCMA) technology. BCMA was designed to reduce medication administration errors, ensuring proper administration of medications by confirming the correct patient, route of administration, dosage, duration, frequency, correct medication, and allergies or interactions. Hospitals that have implemented BCMA reported seeing a greater than a 50 percent reduction in medication administration errors. Many health care facilities have implemented BCMA technologies, while many smaller health facilities did not due to the high cost.

Unfortunately, even after bar-code medication administration technology is implemented, barriers to success can still exist. A study found that among the 2,000 hospitals, 98.7 percent have a BCMA system connected, but only 34.5 percent satisfied the four requirements for effective utilization. These barriers include maintaining a well-trained staff, upgrading or purchasing equipment costs, poor system designs, and errors from health care professionals and health care facilities. Misuse of BCMA technology among health care professionals includes negligence, forgetfulness, hurrying, and being distracted with conversations with patients and their families, while health care facilities can under-report incidents. Obstacles that can burden health care professionals, delay patient care, and increase the risk of medication errors include missing or unreadable medication barcodes, failing batteries, and lack of wireless connectivity. Still, implementing and improving bar-code medication administration technology at every facility is important to improve the quality of care and patient safety.

Amy Dang Craft is a respiratory therapist and a public health graduate student. 


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