Background Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR)
Purpose Incorporate an electronic system of validation and control of cytostatic drug administration using bar codes and an electronic medication-administration system (eMAR).
Materials and methods Bar-codes wristbands have been used to identify patients and The authors acquired PDAs as eMAR, which were connected to e-prescribing program by the hospital WIFI. After having received the medication sent from Pharmacy Department the cytostatic drugs administration circuit in day hospital consists of: the nurse scan the bar codes printed on patient's wristband, automatically drug information about 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 bar code on the patient's wristband the nurse scan the bar code on the medication's labels of cytostatic drugs. Validated variables by the scan are: patient, drug administration sequence, start and end times. If the dose being scanned corresponds to a pharmacist-approved medication 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.
Results During the first month and a half since its introduction, this system has been used in 202 oncology-haematological patients (24.3% haematology, 75.7% oncology patients), 486 medication orders scanned (28.8% haematology and 71.2% oncology) and 1522 doses identified (14.2% haematology and 85.8% oncology). Because the eMAR imports medication orders electronically from either the physician's order entry or the pharmacy system, its implementation may reduce transcription errors. Possible detected errors: incorrect order of administration, already administered drug and selected drug that does not belong to scanned patient. During study period The authors detected: 4 cases of incorrect administration order, 2 cases of already administered drug and 9 cases of selected drug that does not belongs to scanned patient.
Conclusions The implementation of bar-code medication-verification technology embedded in an eMAR in an onco-haematological day hospital act as an additional safety net in medication administration and in patient safety. This system also improves treatment efficiency and achieve a greater interdisciplinary collaboration.
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