Implementing a bar-code assisted medication administration system: effects on the dispensing process and user perceptions.
OBJECTIVE
We assessed the effects of a bar-code assisted medication administration system used without the support of computerised prescribing (stand-alone BCMA), on the dispensing process and its users.


METHODS
The stand-alone BCMA system was implemented in one ward of a teaching hospital. The number of dispensing steps, dispensing time and potential dispensing errors (PDEs) were directly observed one month before and eight months after the intervention. Attitudes of pharmacy and nursing staff were assessed using a questionnaire (Likert scale) and interviews.


RESULTS
Among 1291 and 471 drug items observed before and after the introduction of the technology respectively, the number of dispensing steps increased from five to eight and time (standard deviation) to dispense one drug item by one staff personnel increased from 0.8 (0.09) to 1.5 (0.12) min. Among 2828 and 471 drug items observed before and after the intervention respectively, the number of PDEs increased significantly (P<0.001). 'Procedural errors' and 'missing drug items' were the frequently observed PDEs in the after study. 'Perceived usefulness' and 'job relevance' of the technology decreased significantly (P=0.003 and P=0.004 respectively) among users who participated in the before (N=16) and after (N=16) questionnaires surveys. Among the interviewees, pharmacy staff felt that the system offered less benefit to the dispensing process (9/16). Nursing staff perceived the system as useful in improving the accuracy of drug administration (7/10).


CONCLUSIONS
Implementing a stand-alone BCMA system may slow down and complicate the dispensing process. Nursing staff believe the stand-alone BCMA system could improve the drug administration process but pharmacy staff believes the technology would be more helpful if supported by computerised prescribing. However, periodical assessments are needed to identify weaknesses in the process after implementation, and all users should be educated on the benefits of using this technology.
Department of Medicine, Faculty of Medicine, The University of Hong Kong, Hong Kong. Electronic address: nithushisamaranayake@yahoo.com.
N R
NR
Samaranayake
Department of Pharmacy, Queen Mary Hospital, Hong Kong.
S T D
ST
Cheung
Central Nursing Department, Queen Mary Hospital, Hong Kong.
K
K
Cheng
Central Nursing Department, Queen Mary Hospital, Hong Kong.
K
K
Lai
Department of Pharmacy, Queen Mary Hospital, Hong Kong.
W C M
WC
Chui
Department of Medicine, Faculty of Medicine, The University of Hong Kong, Hong Kong.
B M Y
BM
Cheung
D001291:Attitude of Health Personnel; D004348:Drug Labeling / Q000379:methods*; D001330:Electronic Data Processing; D006284:Health Plan Implementation; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital; D010465:Perception; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D017751:Safety Management
D004364:Pharmaceutical Preparations
Attitudes; Bar-code assisted medication administration (BCMA); Direct observation; Dispensing; Drug administration; Stand-alone BCMA system