Patient Safety and the impacts of Barcode Medication Administration (BCMA)


One of the leading causes of compromising patient safety is adverse medication events. This creates a global challenge to health care systems. Smart technologies are being developed to enhance quality in health care and to assure patient safety. Barcode Medication Administration (BCMA) is a system used to minimize medical errors during the order, transcription, dispensing and administration of medication.

Smart technology such as BCMA has the potential to improve the quality of care through automation, and by helping healthcare professionals in clinical decision making. Smart tools can support communication and collaboration, and the continuity of care. A high level of data security and privacy is required. The barcode medication administration process for example, is regulated by global GS1 standards.

Globally, hospitals have started to introduce BCMA to enable efficient and safe care. However, professionals experience challenges in implementing the system and mistakes still occur. The evaluation of mistakes caused by humans alone is not effective in improving patient safety. The technology and the organisational aspect must be analysed as well.

BCMA helps reduce medications errors. Especially when combined with other systems such as computerized physician´s order entry (CPOE), electronic medicine record (eMAR) and electronic health record (EHR), BCMA helps improves patient safety. Factors that impact the successful use of BCMA are identified as technological, organisational, and social factors.

Technological factors include usability problems, design issues, the compatibility with other systems, connectivity to wifi, and the reliability of the system (system gets stuck easily, the need to press the refresh button frequently to update the system, scanners do not work). Organizational factors include the organisation´s culture, the integration of BCMA into nurses´workflow, the nurses´ work load, deviations from standard procedures, and the quality of collaboration between healthcare staff impact the successful use of BCMA. Social factors that impact technology include users´ perceptions and expectations of BCMA, support, and acceptance.

The identified risk factors associated with the use of BCMA may lead to patient harm. Poorly designed applications, poor integration of the system into the users´workflow, deviations from standard procedures, and lack of training cause problems and impact the quality of care.

Mistakes in the process of medication administration are not eliminated but are reduced when using BCMA. It is important to constantly evaluate smart technology from the technological, the organizational, and the social aspects and not focus on one aspect only. The approach to the introduction of smart technology in healthcare must be balanced. Innovations must be supported, but focus must also be put on safety and quality issues and on the evaluation of the processes.

Irina Heikkinen, Bachelor of Health Care, Nursing, Student in Master’s Degree Programme in Digital Health, Savonia University of Applied Sciences

Elisa Snicker, Lecturer, CBC, MSc (Econ and Bus Admin), MSc (Health Sci.), Savonia University of Applied Sciences, Unit of Continuous Learning, Master School, Kuopio

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