Fifteen best practice recommendations for bar-code medication administration in the Veterans Health Administration.
BACKGROUND
Since 2000, the Veterans Health Administration (VHA) has pioneered the development and deployment of a bar-code medication administration (BCMA) system. Based on VHA experience, 15 "best practices" for BCMA implementation, integration, and maintenance are recommended.


METHODS
Data were collected on potential barriers to the effectiveness of BCMA to improve patient safety by direct observation of medication administration, simulated BCMA use in a laboratory setting, a survey of nursing informatics specialists regarding policies and procedures, and 30 unstructured interviews with diverse stakeholders.


CONCLUSIONS
Fifteen practices were proposed, categorized by implementation and continuous improvement, training, troubleshooting, contingency planning, equipment maintenance, medication administration, and maintenance of paper patient wristbands. For example, Recommendation 15 ("Periodic replacement of wristbands") advises weekly bar-coded wristband replacement in long term care settings to improve the scanning reliability.


CONCLUSIONS
Lessons learned about best practices to address challenges may offer insight to others considering implementation of bar-code technology.
Patterson
Emily S
ES
Getting at Patient Safety Center, Veterans Affairs Medical Center, Cincinnati, USA. patterson.150@osu.edu
Rogers
Michelle L
ML
Render
Marta L
ML
D001330:Electronic Data Processing; D006284:Health Plan Implementation; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008509:Medication Systems / Q000458:organization & administration; D017749:Total Quality Management / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs