Medication errors in hospitals frequently occur at all phases of the prescribing, dispensing, and administration processes. One of the most significant advancements in reducing administration errors has been to provide medications in unit dose packages, which ensures that the medication name, strength, and other characteristics are available during the administration phase.
Providing medication in a unit dose distribution system was implemented by many hospital pharmacies in the 70’s and early 80’s, and is not only considered a best practice, but is now near universal in its application, with millions of unit dose medications dispensed in hospitals and health systems daily, as stated in an editorial in the American Journal Health System Pharmacy (2002).
Not quite universal is the drive to convert to bar-code technology, which represents a promising solution to the medication administration errors, which occur at the bedside. Bar-code technology saves time, improves accuracy, and reduces errors.
The benefits of bar-coding are well documented, such as an article in the Annals of Internal Medicine (2006; 145:426-34) on bar-code safety. The article states that the use of such technology provides reduction in errors, which will result in significant improvements in patient safety. As pharmacists, we know this to be true.
Unfortunately, not all hospitals have implemented this technology due to perceived costs. However, a study in Archives of Internal Medicine (2007) suggests that bar-code technology pays for itself within 5 - 10 years, primarily by providing warnings that can actively help prevent ADE’s and medication errors from occurring.
The most recent advancement in technology to improve patient safety is a bar-code-enabled point-of-care (BPOC) system, whereby medications are administered in bar-coded unit dose packages. For this to be effective, patients wear a bar-coded wristband. When the nurse administers the patient's medications, he or she first scans into the system, then scans the patient’s wristband, and then scans the barcode on the medication, which ensures the right medication reaches the right patient, and is documented in “real time”.
As healthcare pharmacy administrators, we all must be aware that our first obligation is always to the patient. If such technologies prevent just one patient death from an overdose, or the wrong medication, then price becomes secondary.
In my next post, I will discuss the cost structure and other advantages of third-party bar-coded unit dose repackaging for hospital pharmacy. Until then…
Here's to better solutions,
Dave Bystrom
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