NIH’s Clinical Center’s (CC) June newsletter reports that they started using bedside medication barcoding last January as a pilot in selected units with the system fully implemented in March. Barcodes have been used since 2007 for CC admissions. Their use expanded to medications stocked in automated dispensing cabinets in 2009, tracking patients’ lab specimens in 2010, and dispensing take home medications from the outpatient pharmacy in 2011.
When patients are admitted, they receive a wristband which includes a personalized barcode. To begin the medication administration process, the barcode is scanned to pull up the patient’s medication profile on a computer.
Then the staff scans the medication to be administered. The scan of the medication is entered by the prescriber. This prompts a computer to match the medication scanned with the order against the medication dispensing information.
If the data matches the order and the dispensing details, the staff can move forward with medication administration. If the data does not match at any of the steps, then the computer alerts the healthcare professional that medication and order should be reviewed.
CC have used mobile computers called “Workstations on Wheels” (WOW) for many years. However, use of bedside barcoding will increase the volume of traffic on the wireless network. To address this challenge, the NIH Center for Information Technology now provides a wireless network able to reach all areas where patients are being treated.
The Department of Clinical Research Informatics (DCRI) has updated the technology on over 300 WOWs including new computers and in addition, have updated the operating system, wireless scanners, and printers.
In an effort to configure the application, the inpatient pharmacy department reviewed 4,400 medications to ensure that each contained a barcode and those barcodes were included in the database. Scanning the barcodes took over four months to complete and a re-scan of each medication was conducted prior to the pilot and full implementation.
The pharmacy department’s procurement section continues to scan each medication brought into the hospital on a daily basis. The barcodes of new investigational medications released for use by the pharmacy department’s pharmaceutical development section are also tracked. The pharmacy department has scanned over 35,000 barcodes and now over 1,600 new barcodes have been added to the database.
Also, the nurses who provide the medication to patients need to be trained on how to work with the system. The pharmacy department worked with the Department of Clinical Research Informatics (DCRI) to produce a training environment that included training scenarios for hands-on-learning. With much effort, it was possible to get over 700 nurses instructed on using the barcoding technology in just eight weeks.
For more information, go to http://clinicalcenter.nih.gov.