381 / Bar code system for a safe medication management

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Medication / IV Fluids
Health IT There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
The medication administration process is an important source of medication errors. The aim of this Patient Safety Practice is to adopt an additional barrier in the prevention of medication administration errors. The bar code system technology is developed to improve compliance with checking the “five rights” of medication administration: right patient, right route, right drug, right dose and right time. The hospital area to implement it is the chemotherapy day care unit, so this practice could improve the safety in administration chemotherapy medication.
Description of the Patient Safety Practice
 
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.
The aim is to implement bar code assited medication administration (BCMA)to improve patient safety in a chemotherapy unit care reducing administration medication error.

The implementation has consisted on:
1.Putting in place a standing interdisciplinary committee composed by: nursing, pharmacy, computer support, physicians, quality department. Regular meetings.
2.Acquisition of computer material and adaptation of it to the hospital system.
3.Training on BCMA all personnel administering medications.
4.Implementation of the new system by stages in a year period time.
5.Displaying contact information for resources to resolve different types of problems.
6.Evaluation of results.

The assesment is defined by observations using a prospective, before-and-after quasi-experimental study design. The outcomes will be:

-Rate of medication administration errors
-Potential adverse drug events
-Rate of timing errors in medication administration

The total cost to obtain and adapt the technology was 30.000 euros. It consisted on 3 PC, software, program and communication supplies (Wifi). Besides three people were implicated in the implementation during 1 year.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple specialities within the same setting
Involved health care staff
 
Physicians
Nurses
Technical support / technician
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Equipment was not enhanced or new
No motivation among staff
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
To stablish an interdisciplinary committee to troubleshoot when problems arise and to discuss opportunities for continuous improvement.
Continuous short meetings with nursing to share information.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Marta Macías
Country: SPAIN
Organisation: Hospital Universitario Príncipe de Asturias, Madrid
E-mail: marta.maciasm@salud.madrid.org
Phone: There is no specified text here
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