Medication Errors Caused by Negligent Bar Code Medication Administration

Medication errors in a health care setting are rampant despite efforts to solve the problem. The Agency for Healthcare Research and Quality defines an adverse drug event (ADE) as harm experienced by a patient because of exposure to a medication. ADEs account for approximately 700,000 emergency room visits and 100,000 hospitalizations each year. The AHQR estimates that about 5% of hospitalized patients will experience an ADE, which makes them one of the most common types of inpatient hospital errors. A medication error refers to medical mistakes of commission or omission at any step from when a clinician prescribes a medication for a patient and it ends when the patient receives the medication.

According to the LeapFrog Hospital Quality Survey, about 20% of medication errors are life-threatening. Medication errors add more than $7.5 billion per year nationwide in hospital costs alone. That number excludes the costs of medical malpractice insurance and losses in worker productivity.

What is bar code medication administration?

Bar Code Medication Administration (BCMA) systems use an electronic scanning device to scan a bar code on the patient’s wristband to confirm that they are working with the right patient. The nurse then scans the bar code on the medication to verify that they are about the administer the right medication.

The potential for Bar Code Medication Administration to reduce medication errors

The Hospital Quality Institute categorizes medication administration as, “one of the most error-prone processes in health care delivery.” BCMA systems were designed to curb the amount of medication error that were occurring at bedside in hospitals. BCMAs are designed to work with the “Five Rights” of medication administration which include:

1. Right patient
2. Right medication
3. Right dose
4. Right time
5. Right route

The LeapFrog Hospital Quality Survey reports on a study of BCMA and electronic medication administration record (eMAR) systems which found that there was a 41.1% relative reduction in non-timing errors in medication administration, which resulted in a 50.8% relative reduction in potential ADEs which might have been a result of those errors. Using BCMA systems in emergency rooms has also shown a reduction of 80.7% in medication administration errors.

The Hospital Quality Institute reported on a study that evaluated the effects of BCMA technology on reducing medication error rates which began one month before and carried on three months after BCMA implementation in two medical-surgical units and two intensive care units in a 386-bed teaching hospital in southern California.

The study found that implementing BCMA did not affect the total number of medication errors. In fact, researchers observed that there were more distractions, and nurses spent less time explaining medications to patients. There was a noticeable 52% increase in I.V. min-bag errors which occurred after BCMA implementation. The bar code technology can only be effective at preventing medication errors when it supports the nurse’s workflow along with the “five rights.” Fatal medication errors can still occur if nurses and other medical staff do not adhere to the workflow.

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