11:21pm Monday 14 October 2019

BWH Researchers Find That Using Bar-Code Technology With eMAR Drastically Reduces Medication Administration and Transcription Errors

The research appears in the May 6 issue of the New England Journal of Medicine and was funded by the HHS’ Agency for Healthcare Research and Quality.

Bar-code eMAR technology ensures that the correct medication is administered in the correct dose at the correct time to the correct patients.  When nurses use this technology, medication orders appear electronically in a patient’s chart after pharmacist approval.  The technology also alerts nurses electronically if a patient’s medication is overdue.  Before administering medication, nurses are required to scan the bar codes on the patient’s wristband and then on the medication.  If the two don’t match the approved medication order or it is not time for the patient’s next dose, a warning is issued.

Researchers compared 6,723 medication administrations on patient units that did not have bar-code eMAR and 7,318 medication administrations on patient units that did. The implementation of bar coding linked to an eMAR was associated with a 41 percent reduction in non-timing administration errors and a 51 percent reduction in potential drug-related adverse events from these errors. 

Errors in the timing of medication administration fell by 27 percent. Transcription errors and their associated potential drug-related adverse events were essentially eliminated.

“Our study shows that this set of technology can make the delivery of hospital care safer. However, hospitals need the right set of resources and human talent to deploy this technology successfully so more research is needed to identify ways to implement it in the most cost-effective way,” said lead study author Eric G. Poon, M.D., M.P.H. of Brigham and Women’s Hospital, Boston.

“Medication errors in hospitals are a very serious issue and can often lead to patient harm,” said AHRQ Director Carolyn M. Clancy, M.D.  “The good news from this study is that using bar-code technology and an electronic medication administration record together can be an important intervention to achieve medication safety.”
The findings have important implications because bar-code eMAR technology is being considered as a 2013 criterion for “meaningful use” of health information technology under the American Recovery and Reinvestment Act of 2009.

The authors also suggest that decision support embedded within computerized physician-order entry (CPOE) and bar-code eMAR technology would play complementary roles in medication safety efforts.  While CPOE is more likely to prevent errors that result from bad judgment, insufficient knowledge, or incomplete clinical information when choosing a therapeutic plan, bar-code eMAR technology is more likely to prevent errors associated with memory lapses or mental slips in executing a therapeutic plan.  

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