Background Technology has been developed to verify medicines by incorporating barcode verification technology within an electronic medicines-administration system (eMAR barcode) to prevent serious medicines errors during administration of medicines.
Purpose To evaluate the implementation of an electronic system of validation and control of cytostatic drug administration using barcodes and an electronic medicines-administration system (eMAR).
Materials and Methods To identify patients we used barcoded wristbands and we acquired PDAs as eMAR, which were connected to the e-prescribing programme by the hospital WIFI.
After having received the medicine sent from the Pharmacy Department, the nurse scans the barcodes printed on the patient’s wristband, then drug information about the medicines to be administered appears on the screen of the PDA (patient data, route, speed and time of administration, sequence order, components, and number of administrations). After scanning the barcode on the patient’s wristband the nurse scans the barcode on the medicine labels of cytostatic drugs. If the dose being scanned corresponds to a pharmacist-approved medicines order and the patient is due for this dose, administration is automatically documented. However, if the dose does not correspond to a valid order, the application issues a warning. Every action performed with PDAs is recorded in the database.
Results During the first year since its introduction, this system has been used in 709 oncology-haematological and rheumatologic patients (24.8% haematology, 49.1% oncology, 22.6% rheumatology patients), 3995 medicine orders have been scanned (22.2% haematology, 60.2% oncology, 17.6% rheumatology) and 11435 doses identified (12.3% haematology, 80.8% oncology, 6.9% rheumatology).
99.7% of the doses identified with this system were administered while the remaining 0.3% were not administered to patients due to the occurrence of several adverse reactions.
Variables validated by the scan were: patient, drug administration sequence, start and end times. Possible errors detected: incorrect order of administration, drug already administered and drug selected that does not belong to the scanned patient. During the study period we detected 2 cases of selected drug that did not belongs to scanned patient. The system issued a warning that prevented the wrong drug being administered to the patient, probably the worst error with cytostatic drugs administration.
Conclusions The implementation of barcode medicines verification technology embedded in an eMAR in a day hospital acted as an additional safety net in medicines administration and patient safety. This system also improved treatment efficiency and achieved greater interdisciplinary collaboration.
No conflict of interest.
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