title: A System for Anesthesia Drug Administration Using Barcode Technology: The Codonics Safe Label System and Smart Anesthesia Manager.
abstract: BACKGROUND
  Many anesthetic drug errors result from vial or syringe swaps. Scanning the barcodes on vials before drug preparation, creating syringe labels that include barcodes, and scanning the syringe label barcodes before drug administration may help to prevent errors. In contrast, making syringe labels by hand that comply with the recommendations of regulatory agencies and standards-setting bodies is tedious and time consuming. A computerized system that uses vial barcodes and generates barcoded syringe labels could address both safety issues and labeling recommendations.
  
  
  METHODS
  We measured compliance of syringe labels in multiple operating rooms (ORs) with the recommendations of regulatory agencies and standards-setting bodies before and after the introduction of the Codonics Safe Label System (SLS). The Codonics SLS was then combined with Smart Anesthesia Manager software to create an anesthesia barcode drug administration system, which allowed us to measure the rate of scanning syringe label barcodes at the time of drug administration in 2 cardiothoracic ORs before and after introducing a coffee card incentive. Twelve attending cardiothoracic anesthesiologists and the OR satellite pharmacy participated.
  
  
  RESULTS
  The use of the Codonics SLS drug labeling system resulted in >75% compliant syringe labels (95% confidence interval, 75%-98%). All syringe labels made using the Codonics SLS system were compliant. The average rate of scanning barcodes on syringe labels using Smart Anesthesia Manager was 25% (730 of 2976) over 13 weeks but increased to 58% (956 of 1645) over 8 weeks after introduction of a simple (coffee card) incentive (P < 0.001).
  
  
  CONCLUSIONS
  An anesthesia barcode drug administration system resulted in a moderate rate of scanning syringe label barcodes at the time of drug administration. Further, adaptation of the system will be required to achieve a higher utilization rate.
authors.affiliation: From the *Department of Anesthesiology and Pain Medicine, Division of Cardiothoracic Anesthesiology; and †Pharmacy, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Jelacic
authors.forename: Andrew
authors.initials: A
authors.lastname: Bowdle
authors.forename: Bala G
authors.initials: BG
authors.lastname: Nair
authors.forename: Dolly
authors.initials: D
authors.lastname: Kusulos
authors.forename: Lynnette
authors.initials: L
authors.lastname: Bower
authors.forename: Kei
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods / Q000592:standards; D000761:Anesthesia Department, Hospital / Q000379:methods / Q000592:standards; D000777:Anesthetics / Q000008:administration & dosage* / Q000009:adverse effects / Q000592:standards; D004348:Drug Labeling / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D004867:Equipment Design; D004868:Equipment Failure; D019983:Guideline Adherence; D006801:Humans; D008422:Materials Testing; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000592:standards; D017410:Practice Guidelines as Topic; D012985:Software Design; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics