Heather H. Seibert, Pharm.D., M.B.A., is Manager and Clinical Pharmacy Specialist, Centers for Medication Management; and Ray R. Maddox, Pharm. D., FASHP, is Director, Clinical Pharmacy, Research and Pulmonary Medicine, St. Joseph's/Candler Health System, Savannah, GA. Elizabeth A. Flynn, Ph.D., is Independent Research Consultant, Artesia, NM. Carolyn Williams, B.S.Pharm., is Medication Safety Specialist, Clinical Pharmacy, St. Joseph's/ Candler Health System.
Am J Health Syst Pharm. 2014 Feb 1;71(3):209-18. doi: 10.2146/ajhp130332.
The effect of barcode-assisted medication administration (BCMA) with electronic medication administration record (eMAR) technology on the occurrence of medication administration errors was evaluated.
A pretest-posttest nonequivalent comparison group was used to investigate the effect of BCMA-eMAR on the medication administration accuracy rates at two community-based hospitals. Patient care units included three matched pairs in the two hospitals-two medical-surgical, two telemetry, and two rehabilitation units-plus a medical-surgical intensive care unit, an emergency department, and both an inpatient oncology unit and an outpatient oncology service at one of the hospitals. Medication administration accuracy rates were observed and recorded before (phase 1) and approximately 6 and 12 months after (phases 2 and 3, respectively) the implementation of BCMA-eMAR.
The overall accuracy rate at hospital 1 increased significantly from phase 1 (89%) to phase 3 (90%) (p = 0.0015); if wrong-time errors are excluded, the accuracy rate improved from 92% in phase 1 to 96% in phase 3 (p = 0.000008). The overall accuracy rate did not change significantly from phase 1 to phase 3 at hospital 2; when wrong-time errors were excluded from consideration, the accuracy rate improved from 93% in phase 1 to 96% in phase 3 (p = 0.015).
Implementation of BCMA-eMAR in two hospitals was associated with significant increases in total medication accuracy rates in most study units and did not introduce new types of error into the medication administration process. Accuracy rates further improved when wrong-time errors were excluded from analysis. The frequency of errors preventable by BCMA-eMAR decreased significantly in both hospitals after implementation of that technology. BCMA-eMAR and direct observation were more effective than voluntary reporting programs at intercepting and recording errors and preventing them from reaching patients.
评估条形码辅助给药（BCMA）与电子医嘱记录（eMAR）技术联合使用对给药错误发生率的影响。
采用预试验-后试验非等效比较组的方法，调查两家社区医院中 BCMA-eMAR 对给药准确率的影响。患者护理单元包括两家医院的三个匹配对，即两个内科-外科、两个远程监护、两个康复单元，以及一家医院的一个内科-外科重症监护病房、一个急诊室、两个住院肿瘤病房和一个门诊肿瘤服务。在实施 BCMA-eMAR 之前（第 1 阶段）和之后大约 6 个月（第 2 阶段）和 12 个月（第 3 阶段），观察并记录给药准确率。
医院 1 的总体准确率从第 1 阶段（89%）显著提高到第 3 阶段（90%）（p = 0.0015）；如果排除错误时间的错误，准确率从第 1 阶段的 92%提高到第 3 阶段的 96%（p = 0.000008）。医院 2 从第 1 阶段到第 3 阶段，总体准确率没有显著变化；如果将错误时间的错误排除在外，准确率从第 1 阶段的 93%提高到第 3 阶段的 96%（p = 0.015）。
在两家医院实施 BCMA-eMAR 与大多数研究单位的总给药准确率显著提高有关，并且没有在给药过程中引入新类型的错误。排除错误时间后，准确率进一步提高。两家医院实施该技术后，BCMA-eMAR 可预防的错误频率显著降低。BCMA-eMAR 和直接观察比自愿报告程序更有效地拦截和记录错误，并防止它们到达患者。
