van Onzenoort Hein A, van de Plas Afke, Kessels Alfons G, Veldhorst-Janssen Nicole M, van der Kuy Paul-Hugo M, Neef Cees
Department of Clinical Pharmacy and Toxicology, University Hospital Maastricht, Maastricht, Netherlands.
Am J Health Syst Pharm. 2008 Apr 1;65(7):644-8. doi: 10.2146/ajhp070368.
Factors influencing the bar-code verification by nurses during medication administration in a Dutch hospital were studied.
The use of bar-code verification during medication administration in five medical departments was recorded daily for three weeks. These data were collected via electronic medication administration records. The frequency of bar-code verification was calculated as a percentage of all administrations, corrected for the availability of bar-coded packages. Nurses were asked why bar-code verification was not always used. A total of 23,492 medication administrations were recorded, 15,162 (64.5%) of which required bar-code verification. Bar-code verification was significantly influenced by the medical department, deviation between prescribed and administered times, administration route of the drug, number of nurses available in each department, and age of the nurse. The five most cited reasons for not verifying bar codes were difficulties in scanning bar codes on the medication labels, lack of awareness of bar codes on medication labels, delays in responses from the computerized system, shortage of time, and administration of medication before prescription.
Nurses verified the bar codes of only about half of medications administered to patients. Various factors influenced the frequency of bar-code verification by nurses except the number of medications administered. More education regarding medication safety is warranted to increase compliance to a bar-code-enabled point-of-care system.
研究荷兰一家医院中影响护士在给药过程中进行条形码验证的因素。
连续三周每天记录五个医疗科室在给药过程中条形码验证的使用情况。这些数据通过电子给药记录收集。条形码验证的频率以所有给药次数的百分比计算,并根据条形码包装的可用性进行校正。询问护士不总是使用条形码验证的原因。总共记录了23492次给药,其中15162次(64.5%)需要进行条形码验证。条形码验证受到医疗科室、规定时间与给药时间的偏差、药物给药途径、每个科室可用护士数量以及护士年龄的显著影响。不进行条形码验证最常被提及的五个原因是药物标签上的条形码扫描困难、对药物标签上条形码的认识不足、计算机系统响应延迟、时间短缺以及在处方前给药。
护士仅对约一半给患者使用的药物进行了条形码验证。除给药数量外,多种因素影响护士进行条形码验证的频率。有必要开展更多关于用药安全的教育,以提高对启用条形码的床边护理系统的依从性。