Barcode Medication Administration (BCMA)

Presented By:

Amrita SinghKeneikhrienuo

Contents Barcode Introduction

Anatomy

Hardware Model

Software Model

Standards

Advantages & Disadvantages

Competencies

Electronic software application

Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computer

First developed 1995 VA Medical Center Topeka, Kansas

Introduced nationwide in 2000

What is BCMA?

(Wideman, Whittler, & Anderson, n.d.)

1. Physician order received

2. Order faxed to Pharmacy

3. Pharmacists edit and verify electronic orders into patient

profile

4. Pharmacy dispenses ordered medications in Bar-Coded

packages

5. Nurse accesses BMCA software on computer via log on

6. Nurse scans unique patient bar-coded ID band

BCMA Basic Steps

• The Five Rights of Barcode Medication Administration:

The right patient

The right medication

At the right time

At the right dose

By the right route

Hardware Model

BCMA

Wireless PC

Scanner

Keyboard

Barcodes

Barcode Scanning Device

• Light weight and comfortable hand held design

• Built in decoder

• Emits high intensity red aiming beam

• Trigger button

Software

Siemens Med Administration Check (MAC)

• Siemens Pharmacy

• INVISION

• Chart-Assist

• Interface with LCR and PYXIS Connect

( Siemens 2005)

Software MACMAC is a nursing application

Database collects, sorts, organizes, and stores information

Database allows nurse to easily retrieve select and aggregate data

Open MAC application using login id and password

Select patient from database

All patients information is stored on database

Standards • When multiple parties or companies are involved in the ID

process, industry standards are usually established

• The standard is not necessarily the same as the barcode

symbology

• Barcode standards define how to use the barcode symbology

in a particular situation

• ISBN is a standard for labeling books

• Periodicals that uses the EAN-13 symbology

User friendly

Easily learned

Overall department satisfaction with use

Access information easily

Interface achieves particular goals

Error tolerance

Usability

Advantages

• Improves medication administration flow with online work list

• Checks for five rights at the point of care with bar code

technology

• Drives online MAR documentation, charging, inventory control

• Uses proven point of care technology options

• Is designed for acute, ambulatory, long term care environment

Advantages

• Provides value added clinical and operation integration

• Can include assessment and process redesign consulting

services

• Compatible with any automated drug dispensing device and

drug wholesaler

• Assesses for pain by prompting a pain scale when

administering analgesics

Disadvantages

• Not foolproof

• Bar codes mismatch with drug, dose, and patient at times

• Bar code sometimes function erroneously

• Unable to scan bar codes properly at times

• Duplicate patient identification bar codes have been scanned

for multiple patients

Disadvantages

• Carrying several patients pre-scanned medications on one

tray

• Disabling system alarms to avoid disturbing their patients

• Unreadable bar codes

• Emergency Situations

• Time consuming

Ethical/Legal Issues

Potential problems in regards to HIPPA

• Leaving the computer in the hallway with patient name and identity exposed

• Nurses not logging off the software application

• Unethical/ethical in regards to overrides

Competencies

• Clinicians have various technological backgrounds

• Users were accessible to staff every shift 24 hours

• Workshops are initiated

• Need successful completion of the course

Competencies

• Staff representatives include inpatient pharmacist, ICU nurse,

ward nurse, and a nursing instructor

• Ongoing refresher courses offered

• Job shadowing

• Multidisciplinary cross training techniques increase staff

understanding and competency

Conclusion

• Technology at work at the bedside

• Increasing safety

• Increasing continuity of care

• Increasing satisfaction among staff

• Increasing communication

Functions & Responsibilities of Informatics Nurses working with BMCA

• Incorporate theories, principles, and concepts from appropriate sciences and evidence based practice

• Integrate ergonomics and human-computer interaction principles appropriately and efficiently

• Systematically determine the social, legal, and ethical impact and play an active role in system improvement

(McGonigle & Mastrian, 2009)

Conclusion

• Decreases medication errors

• Decreases law suits

• Regardless of some small disadvantages the application can

be improved over time

• Opens new windows and doors for communication and safety

References

• Technology for Long Term Care. (2008). Barcode Medication

Administration. Retrieved February 15, 2009, from Technology

for Long term Care Web site: http://www.techforltc.org

• McGonigle, D., & Mastrian, K. (Eds.). (2009). Nursing

Informatics and the Foundation of Knowledge. Mississauga,

Ontario Canada: Jones and Bartlett.