Using bar-code technology can substantially reduce transcription and medication errors, and prevent potential adverse events, according to a new study funded by the Agency for Healthcare Research and Quality.
Researchers at Brigham and Women's Hospital in Boston compared error rates in order transcription and medication administration at an academic medical center before and after it implemented a bar-code electronic medication-administration system (eMAR). The eMar system sends electronic alerts when a patient's medication is overdue or if there is a mismatch between the bar codes on a patient's wristband and the medication.
Of the 14,041 medication administrations and 3082 order transcriptions researchers reviewed, they noted 776 errors unrelated to timing on intensive care units that did not use the bar-code eMAR, compared to just 495 on units that had implemented the system--a 41.4% relative reduction in errors.
The rate of potential adverse drug events also fell just over 50%, and the rate of timing errors in medication administration dropped by 27.3%. The authors extrapolated those results to estimate the potential impact on the hospital over the course of a year.
"Because the study hospital administers approximately 5.9 million doses of medications per year, use of the [bar code system] is expected to prevent approximately 95,000 potential adverse drug events at the point of medication administration every year in this hospital," researchers wrote in their report, which was published in the May 6 issue of the New England Journal of Medicine.
In addition, they expect the technology to reduce the number of early or late medication administrations by 270,000 per year and to prevent approximately 50,000 potential adverse drug events related to transcription errors.
The effect of bar-code technology was similar to that of computerized physician-order entry, which can reduce medication errors at the ordering stage by 55%. The authors noted that CPOE is effective in preventing errors resulting from bad judgment or insufficient knowledge, whereas the bar-code system is more likely to prevent errors caused by mental lapses. They recommend using the two in conjunction for maximum effectiveness.
"The two technologies would probably play complementary roles in improving medication safety in acute care hospitals," they wrote.