Bar-coded Medication Administration: Keen Eye Required

By Kim Maryniak, RNC, MSN

We are in an age of radical change in healthcare, and at the forefront is the integration of technological advances. Electronic health records, “smart” infusion pumps, automated medication dispensing, and bar-coded medication administration are just a few of the new technologies being used. Many studies have demonstrated how appropriate use of these tools improves safety in patient care.

Bar-coded medication administration (BCMA) systems can be a challenge for nurses to learn and incorporate into practice. As a result, despite the statistical evidence that BCMA contributes to a significant decrease in errors, some nurses continue to voice frustration about the “extra steps” required to administer medications. However, overriding or implementing a “work-around” is more dangerous. Many organizations have quality goals for limiting the number of overrides with BCMA - typically less than 5%.

On the other hand, sole reliance on technologies can be detrimental.  These programs, like humans, still have room for error. Therefore, it is the responsibility of the nurse to ensure that the patient rights of medication administration are upheld.  In fact, due diligence by nurses have actually caught mislabeling errors/potential misidentification, and in doing so, have protected the safety of their patients.  

In the end, improved patient safety is optimal when the appropriate use of technologies is coupled with  verification by a healthcare professional.

Early, C., Riha, C., Martin, J., Lowdon, K., & Harvey, E.  (2011). Scanning for safety: An integrated approach to improved bar-code medication administration.  CIN: Computers, Informatics & Nursing, 29(3), 157-164. 

Poon, E.G., Keohane, C.A., Yoon, C.S. & Gandhi, T.K.  (2010).  Effect of bar-code technology on the safety of medication administration. New England Journal of Medicine, 362, 1698-1707.

Snyder, M. L. Carter, A., Jenkins, K. & Fantz, C. R.  (2010). Patient misidentifications caused by errors in standard bar code technology. Clinical Chemistry, 56(10),1554-60.


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Kim Maryniak, RNC, MSN is currently a Clinical Director with AMN Healthcare. She has more than 22 years of nursing experience, including med/surg, psychiatry, pediatrics, neonatal intensive care, education and management.