Document Detail

Effect of bar-code technology on the safety of medication administration.
MedLine Citation:
PMID:  20445181     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: 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 (bar-code eMAR).
METHODS: We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events.
RESULTS: We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate)--a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the bar-code eMAR but were completely eliminated on units that did use it.
CONCLUSIONS: Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety. ( number, NCT00243373.)
Eric G Poon; Carol A Keohane; Catherine S Yoon; Matthew Ditmore; Anne Bane; Osnat Levtzion-Korach; Thomas Moniz; Jeffrey M Rothschild; Allen B Kachalia; Judy Hayes; William W Churchill; Stuart Lipsitz; Anthony D Whittemore; David W Bates; Tejal K Gandhi
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  362     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-05-13     Revised Date:  2012-12-31    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1698-707     Citation Subset:  AIM; IM    
Copyright Information:
2010 Massachusetts Medical Society
Division of General Medicine Primary Care, Brigham and Women's Hospital, 3/F, 1620 Tremont St., Boston, MA 02120, USA.
Data Bank Information
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MeSH Terms
Academic Medical Centers / organization & administration
Automatic Data Processing*
Drug Administration Schedule
Medical Order Entry Systems*
Medication Errors / prevention & control*,  statistics & numerical data
Medication Systems, Hospital*
Organizational Case Studies
Organizational Innovation
Pharmaceutical Preparations / administration & dosage*,  adverse effects
United States
Grant Support
HS14053-02/HS/AHRQ HHS
Reg. No./Substance:
0/Pharmaceutical Preparations
Comment In:
N Engl J Med. 2010 Aug 12;363(7):698; author reply 698   [PMID:  20701535 ]
Virtual Mentor. 2011;13(3):167-9   [PMID:  23127318 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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