Improving ScannED Medications
Amanda Cothran, BSN, CEN; Nicholas Harmon, BSN, RN; Kevin Smith, Jr., ADN, RN
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Session H presented Saturday, September 16, 2017
Purpose: Barcode medication verification has been proven to be an effective safety measure to help prevent errors during medication administration. It is necessary to provide safe medication administration to ensure quality care but verification still remains an opportunity within the emergency department. The objective of our project was to improve the overall safety of medication administration and reduce the rate of administration errors within the ED by ensuring that medications were scanned using a barcode verification system.
Design: This project was designed for quality assurance. The goal for bedside medication verification (BVM) using a scanned barcode method is 80%. It was recognized that goal was not being met regularly. Education, staff awareness, and frontline staff involvement were all part of the Action Plan development to ensure quality measures were improved. <>/p>
Setting: Maury Regional Health is a not-for-profit regional health system serving southern Middle Tennessee through its hospitals, clinics, surgery centers, outpatient facilities and physician practice group. Maury Regional Health is the largest health care provider between Nashville, Tennessee and Huntsville, Alabama. Maury Regional Medical Center in Columbia serves as the flagship hospital for the system. The facility includes 255 beds and a growing medical staff of more than 200 physicians.
Participants/Subjects: All ED RN staff were inclucded in this quality assurance initiative. Employee ID numbers were utilized for displaying the results within the department. No patient information was shared or used to collect data for this project.
Methods: Initiative was reintroduced by ED leadership during June 2015 staff meetings, setting expectations of scanning medications moving forward. ED Unit Council heralded the initiative to post scan rates withinin the department monthly, along with the accountability plan for those who did not meet the safety expectation. Data was collected for rate of medications scanned and rate of patients scanned using reports available through the facility's documentation system. The data was presented initially quartely, then monthly, to the ED RN staff with a reiteration of the expectation and the consequences for not meeting the standard patient safety expectation.
Results/Outcomes: The BVM scan rates within the Emergency Department dramatically increased from 52% to 85% in little over a year with continued presentation of real time data. The data was presented to the staff monthly and quantified quarterly. Individual low performers were counseled and re-educated. Reporting of system errors including medications not scanning and computers malfunctioning increased exponentially.
Implications: The quality initiative is ongoing. We predict that continued improvements wiill be made not only with BVM but with medication administration overall, thusly increasing the overall goal of patient safety within the emergency department. Long term goal is that our scan rate benchmark will be increased 90% or greater as individual metrics improve.
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