Recognizing the institutional benefits of bar-code point-of-care technology.
BACKGROUND: The application of bar-code technology to medication administration is growing, and its benefits are increasingly recognized. This article describes a hospital's experience with bar-code point-of-care (BPOC) technology and discusses the benefits of BPOC, considers the essential role of the pharmacist when implementing BPOC in a hospital setting, and provides a financial model for cost avoidance using a BPOC system. IMPLEMENTING BPOC: In 1998 Northern Michigan Regional Health System (Petoskey, Mich) partnered with a software company to create a BPOC system. Major milestones associated with implementation were involving and preparing end users, examining the hospital's entire medication process, updating the formulary and mapping drugs accurately, and identifying a process to maximize bar-code label attachment to medications. RESULTS: Visibility of prevented errors increased as compared with occurrence reports. Among the prevented errors, approximately 25% of the not-due errors occurred between shifts or between caregivers; wrong-dose errors included nurse attempts to give one tablet when two were ordered and giving two tablets when one was ordered; and wrong-patient errors were predominantly associated with intravenous piggyback medications. Omitted doses or missed doses were virtually eliminated by BPOC. DISCUSSION: A BPOC system provides a much-needed safety net at the bedside to avert potentially injurious medication errors. Another benefit that a BPOC system provides is a record of actual medication administrations. Conducting a thorough assessment of a hospital's readiness for a BPOC system will guide system implementation and help avoid potential installation pitfalls.