title: Effect of barcode-assisted medication administration on emergency department medication errors.
abstract: OBJECTIVE
  Barcode-assisted medication administration (BCMA) is technology with demonstrated benefit in reducing medication administration errors in hospitalized patients; however, it is not routinely used in emergency departments (EDs). EDs may benefit from BCMA, because ED medication administration is complex and error-prone.
  
  
  METHODS
  A naïve observational study was conducted at an academic medical center implementing BCMA in the ED. The rate of medication administration errors was measured before and after implementing an integrated electronic medical record (EMR) with BCMA capacity. Errors were classified as wrong drug, wrong dose, wrong route of administration, or a medication administration with no physician order. The error type, severity of error, and medications associated with errors were also quantified.
  
  
  RESULTS
  A total of 1,978 medication administrations were observed (996 pre-BCMA and 982 post-BCMA). The baseline medication administration error rate was 6.3%, with wrong dose errors representing 66.7% of observed errors. BCMA was associated with a reduction in the medication administration error rate to 1.2%, a relative rate reduction of 80.7% (p < 0.0001). Wrong dose errors decreased by 90.4% (p < 0.0001), and medication administrations with no physician order decreased by 72.4% (p = 0.057). Most errors discovered were of minor severity. Antihistamine medications were associated with the highest error rate.
  
  
  CONCLUSIONS
  Implementing BCMA in the ED was associated with significant reductions in the medication administration error rate and specifically wrong dose errors. The results of this study suggest a benefit of BCMA on reducing medication administration errors in the ED.
authors.affiliation: Wexner Medical Center, The Ohio State University, Columbus, OH; Department of Pharmacy, The Ohio State University, Columbus, OH.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bonkowski
authors.forename: Cynthia
authors.initials: C
authors.lastname: Carnes
authors.forename: Joseph
authors.initials: J
authors.lastname: Melucci
authors.forename: Jay
authors.initials: J
authors.lastname: Mirtallo
authors.forename: Beth
authors.initials: B
authors.lastname: Prier
authors.forename: Erin
authors.initials: E
authors.lastname: Reichert
authors.forename: Susan
authors.initials: S
authors.lastname: Moffatt-Bruce
authors.forename: Robert
authors.initials: R
authors.lastname: Weber
mesh_terms: D001330:Electronic Data Processing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital; D009820:Ohio