Barcode Medication Administration (BCMA) Presented By: Amrita Singh Keneikhrienuo Contents Barcode Introduction Anatomy Hardware Model Software Model Standards Advantages & Disadvantages Competencies What is BCMA? Electronic software application Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computer First developed 1995 VA Medical Center Topeka, Kansas Introduced nationwide in 2000 (Wideman, Whittler, & Anderson, n.d.) BCMA Basic Steps 1. Physician order received 2. Order faxed to Pharmacy 3. Pharmacists edit and verify electronic orders into patient profile 4. Pharmacy dispenses ordered medications in Bar-Coded packages 5. Nurse accesses BMCA software on computer via log on 6. Nurse scans unique patient bar-coded ID band • The Five Rights of Barcode Medication Administration: The right medication By the right route The right patient At the right dose At the right time Hardware Model Wireless PC Barcodes BCMA Keyboard Scanner Barcode Scanning Device • Light weight and comfortable hand held design • Built in decoder • Emits high intensity red aiming beam • Trigger button Software Siemens Med Administration Check (MAC) • Siemens Pharmacy • INVISION • Chart-Assist • Interface with LCR and PYXIS Connect ( Siemens 2005) Software MAC MAC is a nursing application Database collects, sorts, organizes, and stores information Database allows nurse to easily retrieve select and aggregate data Open MAC application using login id and password Select patient from database All patients information is stored on database Standards • When multiple parties or companies are involved in the ID process, industry standards are usually established • The standard is not necessarily the same as the barcode symbology • Barcode standards define how to use the barcode symbology in a particular situation • ISBN is a standard for labeling books • Periodicals that uses the EAN-13 symbology User friendly Easily learned Overall department satisfaction with use Access information easily Interface achieves particular goals Error tolerance Advantages • Improves medication administration flow with online work list • Checks for five rights at the point of care with bar code technology • Drives online MAR documentation, charging, inventory control • Uses proven point of care technology options • Is designed for acute, ambulatory, long term care environment Advantages • Provides value added clinical and operation integration • Can include assessment and process redesign consulting services • Compatible with any automated drug dispensing device and drug wholesaler • Assesses for pain by prompting a pain scale when administering analgesics Disadvantages • Not foolproof • Bar codes mismatch with drug, dose, and patient at times • Bar code sometimes function erroneously • Unable to scan bar codes properly at times • Duplicate patient identification bar codes have been scanned for multiple patients Disadvantages • Carrying several patients pre-scanned medications on one tray • Disabling system alarms to avoid disturbing their patients • Unreadable bar codes • Emergency Situations • Time consuming Ethical/Legal Issues Potential problems in regards to HIPPA • Leaving the computer in the hallway with patient name and identity exposed • Nurses not logging off the software application • Unethical/ethical in regards to overrides Competencies • Clinicians have various technological backgrounds • Users were accessible to staff every shift 24 hours • Workshops are initiated • Need successful completion of the course Competencies • Staff representatives include inpatient pharmacist, ICU nurse, ward nurse, and a nursing instructor • Ongoing refresher courses offered • Job shadowing • Multidisciplinary cross training techniques increase staff understanding and competency Conclusion • Technology at work at the bedside • Increasing safety • Increasing continuity of care • Increasing satisfaction among staff • Increasing communication Functions & Responsibilities of Informatics Nurses working with BMCA • Incorporate theories, principles, and concepts from appropriate sciences and evidence based practice • Integrate ergonomics and human-computer interaction principles appropriately and efficiently • Systematically determine the social, legal, and ethical impact and play an active role in system improvement (McGonigle & Mastrian, 2009) Conclusion • Decreases medication errors • Decreases law suits • Regardless of some small disadvantages the application can be improved over time • Opens new windows and doors for communication and safety References • Technology for Long Term Care. (2008). Barcode Medication Administration. Technology Retrieved for Long February term 15, Care 2009, from Web site: http://www.techforltc.org • McGonigle, D., & Mastrian, K. (Eds.). (2009). Nursing Informatics and the Foundation of Knowledge. Mississauga, Ontario Canada: Jones and Bartlett.