Recognizing the institutional benefits of bar-code point-of-care technology.
BACKGROUND
The application of bar-code technology to medication administration is growing, and its benefits are increasingly recognized. This article describes a hospital's experience with bar-code point-of-care (BPOC) technology and discusses the benefits of BPOC, considers the essential role of the pharmacist when implementing BPOC in a hospital setting, and provides a financial model for cost avoidance using a BPOC system. IMPLEMENTING BPOC: In 1998 Northern Michigan Regional Health System (Petoskey, Mich) partnered with a software company to create a BPOC system. Major milestones associated with implementation were involving and preparing end users, examining the hospital's entire medication process, updating the formulary and mapping drugs accurately, and identifying a process to maximize bar-code label attachment to medications.


RESULTS
Visibility of prevented errors increased as compared with occurrence reports. Among the prevented errors, approximately 25% of the not-due errors occurred between shifts or between caregivers; wrong-dose errors included nurse attempts to give one tablet when two were ordered and giving two tablets when one was ordered; and wrong-patient errors were predominantly associated with intravenous piggyback medications. Omitted doses or missed doses were virtually eliminated by BPOC.


CONCLUSIONS
A BPOC system provides a much-needed safety net at the bedside to avert potentially injurious medication errors. Another benefit that a BPOC system provides is a record of actual medication administrations. Conducting a thorough assessment of a hospital's readiness for a BPOC system will guide system implementation and help avoid potential installation pitfalls.
Larrabee
Susanne
S
Northern Michigan Regional Health System, Petoskey, Michigan, USA.
Brown
Mary-Michael
MM
D016303:Clinical Pharmacy Information Systems; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D020000:Decision Support Systems, Clinical; D001330:Electronic Data Processing; D006744:Hospital Bed Capacity, 100 to 299; D006801:Humans; D007324:Institutional Management Teams; D007857:Leadership; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D008824:Michigan; D019095:Point-of-Care Systems; D012984:Software