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Effect of bar-code technology on the safety of medication administration.

Publication ,  Journal Article
Poon, EG; Keohane, CA; Yoon, CS; Ditmore, M; Bane, A; Levtzion-Korach, O; Moniz, T; Rothschild, JM; Kachalia, AB; Hayes, J; Churchill, WW ...
Published in: The New England journal of medicine
May 2010

Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR).We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events.We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate)--a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the bar-code eMAR but were completely eliminated on units that did use it.Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety. (ClinicalTrials.gov number, NCT00243373.)

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Published In

The New England journal of medicine

DOI

EISSN

1533-4406

ISSN

0028-4793

Publication Date

May 2010

Volume

362

Issue

18

Start / End Page

1698 / 1707

Related Subject Headings

  • United States
  • Pharmaceutical Preparations
  • Organizational Innovation
  • Organizational Case Studies
  • Medication Systems, Hospital
  • Medication Errors
  • Medical Order Entry Systems
  • Humans
  • General & Internal Medicine
  • Electronic Data Processing
 

Citation

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Poon, E. G., Keohane, C. A., Yoon, C. S., Ditmore, M., Bane, A., Levtzion-Korach, O., … Gandhi, T. K. (2010). Effect of bar-code technology on the safety of medication administration. The New England Journal of Medicine, 362(18), 1698–1707. https://doi.org/10.1056/nejmsa0907115
Poon, Eric G., Carol A. Keohane, Catherine S. Yoon, Matthew Ditmore, Anne Bane, Osnat Levtzion-Korach, Thomas Moniz, et al. “Effect of bar-code technology on the safety of medication administration.The New England Journal of Medicine 362, no. 18 (May 2010): 1698–1707. https://doi.org/10.1056/nejmsa0907115.
Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, et al. Effect of bar-code technology on the safety of medication administration. The New England journal of medicine. 2010 May;362(18):1698–707.
Poon, Eric G., et al. “Effect of bar-code technology on the safety of medication administration.The New England Journal of Medicine, vol. 362, no. 18, May 2010, pp. 1698–707. Epmc, doi:10.1056/nejmsa0907115.
Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, Moniz T, Rothschild JM, Kachalia AB, Hayes J, Churchill WW, Lipsitz S, Whittemore AD, Bates DW, Gandhi TK. Effect of bar-code technology on the safety of medication administration. The New England journal of medicine. 2010 May;362(18):1698–1707.

Published In

The New England journal of medicine

DOI

EISSN

1533-4406

ISSN

0028-4793

Publication Date

May 2010

Volume

362

Issue

18

Start / End Page

1698 / 1707

Related Subject Headings

  • United States
  • Pharmaceutical Preparations
  • Organizational Innovation
  • Organizational Case Studies
  • Medication Systems, Hospital
  • Medication Errors
  • Medical Order Entry Systems
  • Humans
  • General & Internal Medicine
  • Electronic Data Processing