Professional Documents
Culture Documents
Barcoding:
University of Mary
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Introduction:
When becoming a nurse, there are certain philosophies and ideologies that are integral to
providing a client with holistic care. One of these philosophies is ensuring the safety of the client
imperative that a nurse not only understands the system, but knows the intended purpose of
utilizing it, how it affects client care, and how to avoid errors when using the system. By being
educated and properly trained on using barcoding systems, nurses can avoid wastes of up to $3.5
billion annually as well as prevent errors that put about 1.5 million people in danger every year
(Da Silva & Krishnamurthy, 2016). In order to avoid such large numbers of medication errors,
one first must understand how barcoding works. What this system allows health care team
members to do is ensure that the right patient is receiving the right medication in the right dose,
through the right route, at the right time. By having a system that checks these five rights, it will
show the nurse that there is some sort of inconsistency to stop any medications that violate those
rights. It is integral to have a system that does this, as it further emphasizes the importance of
Client safety is one of the significant priorities in every healthcare facility. Over the
years, the discovery of Barcode Medication Administration (BCMA) made a significant impact
in preventing medical errors. This technology primarily focuses on client and medication
identification. BCMA is widely used across different healthcare facilities in the United States
and progressively develops in other countries. It gained popularity because of its ease of access
and instant verification approach. According to a journal by The Pharma Innovation, barcodes
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are used for client identification, medication management, and tracking of medical supplies in
hospitals (Alli, 2021). Client identification is a vital constituent of client safety before providing
any medical intervention. Upon admission to hospitals, clients are given barcode bands which
are an essential part of the identification process in BCMA. It contains integrated data of the
client and is connected to the client's medical database. For the BCMA to work, the nurse needs
to scan the client's barcode band and the medication's barcode before medication administration.
Once scanned, the system electronically verifies the "5 rights" of medication administration --
right client, right dose, right drug, right time, right route -- at the client's bedside (Shah et al.,
2016). After the data is validated, the system notifies the nurse if the medication or the client is
incorrect, providing the nurse a chance to review and fix the error before proceeding to the
medication administration (Truitt et al., 2016). This statement would signify the importance of
would still be possible to occur at any moment. Aside from mitigating medication errors, BCMA
increases the efficiency of medication administration. The connection between BCMA and the
client's electronic health record (EHR) makes it easier for the healthcare providers to monitor the
client's progress and medication intake with proper documentation. In the documentation
process, health care providers can utilize the system to leave notes and coordinate with other
There are several security purposes in place in order to keep sensitive client information
from those who are not meant to access that information. This is a concept that is incredibly
important to nursing and the care nurses give to clients in their care. So, when barcoding systems
came into the healthcare world, there needed to be precautions in place to prevent security
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breaches. There needs to be proper training on the subject, so the staff utilizing the system know
potential security breaches and tracking to see who is accessing what files at what time. Cinahl
Information Systems released an informational paper to explain the important facts about
barcoding, putting in specific that “training should be thorough” as a means of being comfortable
with usage to eliminate mistakes (Woten & Karakashian, 2017). To actually use the technology,
nurses are required to login to a client’s electronic health record and scan not only their barcode,
but the medication being given to them, allowing the nurse to ensure the medication being given
is the right one (Strudwick et al., 2017). This would imply that, had the nurse logged into the
right EHR in the wrong room, the information would be protected, as the barcoding system
would alert them that the client barcode that was scanned was not the same one in the EHR they
are looking at. By having the feature of needing to be logged in to a particular client’s record, it
avoids the mistake of a nurse seeing a client’s information that is not theirs. There are certain
programs in place by companies, such as EMS Barcode Solutions, that track when a particular
nurse is using the barcoding system and on what item (EMS Barcoding Solutions, 2021). This is
another way that, if there is some breach in security, there can be a record of what nurse it was
recorded under in the system to narrow down who is not following HIPAA regulations. There are
other very simple, very manageable ways that health care members can be conscientious of the
information that is meant to stay private. One example is ensuring that there is no one behind the
computer when getting into the EHR. Not only is it a good habit to have when administering
medication, but in general will ensure the client’s information is protected whenever the EHR is
trained, understands the system, and is conscientious of vulnerable moments in accessing client
information would allow for the barcoding systems to maintain client confidentiality.
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Quality
One of the major benefits of BCMA is that it reduces the number of medication errors.
This is because BCMA provides a simple technological solution to improve safety in the
preparation and management of administering medication. It acts as a barrier that can prevent
adverse events by aiding the nurse in checking the five rights of medication administration: the
right client, the right medicine, the right dose, the right path, and the right time (Daus et al.,
2017). One way that BCMA does this is by certifying that the barcode of the medication matches
the identification tag of the client. This ensures that medications are safely administered to the
correct client. BCMA also protects clients and helps nurses provide quality care by preventing
human errors that can arise from lack of concentration and fatigue. With the implementation of
BCMA, the rates of harmful medication errors decreased from 0.65 per 100,000 medications
before the intervention to 0.29 per 100,000 medications after the intervention (Thompson et al.,
2018). Another benefit of BCMA is that it enhances infection control practices. This is because
non-touch technique verification with handheld devices is utilized and can be conveniently
disinfected with alcohol wipes because of their small size. This eliminates the need to bring
mobile carts into the room as they can be stationed outside of a client’s cubicle to prevent
exposure to infectious diseases and cross-contamination to other clients (Naidu & Alicia, 2019).
cybersecurity issues. This is because BCMA cannot be utilized without an electronic medication
administration record (e-MAR). An e-MAR contains client’s information online which exposes it
to cyber-attacks and ransomware. Hackers could use this information to hold medical data
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hostage until they receive money. This results in slowing down of work and violation of a
client’s privacy and confidentiality. Another disadvantage of BCMA are the technical difficulties
that can arise. For example, some barcodes on medications could be mislabeled, wristbands
could be difficult to scan, or confusing computer screen displays can result in technology-related
technological issues could arise that would need to be solved with the assistance of the vendor.
All of these threaten the quality care and safety of the client (Woten & Karakashian, 2017).
Glenna Sue Kinnick. She piloted this idea with the intention of improving client safety by
reducing medication errors. It was an idea that stemmed from a rental car check-in system that
she observed in 1992 (Sherman, 2013). In 1997, BCMA was being utilized in all VA hospitals,
and in 2003, the FDA recommended the implementation of BCMA in all hospitals throughout
the United States. Over the years, BCMA has evolved from a portable radio terminal paired with
ultra-high frequency band radio waves to graphical user interface combined with wireless
connectivity (Indian Health Service, 2021). This development in technology was impart to
specialists. From this, it is evident that nurses have had a vital role in the development of BCMA
over the years. Regarding implementation and evaluation, BCMA helps nurses identify
problems, devise plans for improvement, and track improvement over time, all of which helps
nurses serve as strong client advocates. Before administering a medication, the nurse scans both
the armband and the barcode on the medication. BCMA technology certifies that the nurse
administers the medication correctly to the correct client. If the medication or client is incorrect,
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the nurse is notified, giving the nurse opportune time to correct the error before administering the
Conclusion:
medication errors as a result due to eliminating the chance for human error. The system can also
alert the healthcare team of any violations to the client’s five rights of medication administration
for further review from the team member. Before the team is able to utilize the system, there
must be training that ensures workers understand the purpose of the system, how it works, and
why each alert should be paid attention to no matter what. There does need to be further research
in order to keep protected information from being accessed, whether it be within the people on
the floor or through cybersecurity breaches. While those are pressing issues with the current
system in place, there is still significant impact on the nursing role and integration of client care.
By having a system that checks the client’s rights of medication administration alongside the
nurse, as well as a system that assists with documenting the information with accuracy due to it
being a program. BCMA allows to cut out the error that comes with being human, ensuring the
utmost safety for the clients that come into a nurse’s care.
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References
Alli, A., SK, Md. (2020, December 12). 9-12-67-816 [PDF]. Prayagraj: The Pharma Innovation
https://www.thepharmajournal.com/archives/2021/vol10issue1/PartC/9-12-67-816.pdf
Da Silva, B., & Krishnamurthy, M. (2016, September 7). The Alarming Reality of Medication
Error: A Patient Case and Review of Pennsylvania and National Data. Retrieved March
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016741/#:~:text=Economic%20impact
%20(United%20States)&text=Medication%20errors%20harm%20an%20estimated,
(3)%20(N).
Daus, M., Maydana, T., Rizzato Lede, D., & Luna, D. (2017). Enhancing Children’s Safety by
EMS Barcoding Solutions (2021). Healthcare barcode Systems. Retrieved March 10, 2021, from
https://www.emsbarcode.com/healthcare-barcode-systems/
Indian Health Service (2021). Technical overview. Retrieved March 10, 2021, from
https://www.ihs.gov/bcma/technicaloverview/#:~:text=BCMA%20runs%20upon%20the
%20same,connectivity%20or%20with%20bedside%20workstations
Naidu, M., & Alicia, Y. L. Y. (2019). Impact of Bar-Code Medication Administration and
https://doi.org/10.4236/health.2019.115044
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Shah, K., Lo, C., Babich, M., Tsao, N., & Bansback, N. (2016, October 31). Bar code medication
with computerized prescriber order entry and automated dispensing devices. Retrieved
Sherman, R. O. (2013, January 31). Leading from Where You Stand. Emerging Nurse Leader.
Strudwick, G., Clark, C., McBride, B., Sakal, M., & Kalia, K. (2017). International Journal of
Medical Informatics. Thank You for Asking: Exploring Patient Perceptions of Barcode
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1386505617301685?
scrollTo=%23hl0000293.
Thompson, K., Swanson, K., Cox, D., Kirchner, R., Russell, J., Wermers, R., . . . Naessens, J.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257885/
Truitt, E., Thompson, R., Blazey-Martin, D., Nisai, D., & Salem, D. (2016). Effect of the
https://doi.org/10.1310/hpj5106-474
Woten, M., RN, BSN, & Karakashian, A. L., RN, BSN. (2017, October 27).
content/NRCP_Implementing-a-Bar-Code-System_NSP.pdf