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Why barcode medications? Admin Rx at the Medical University of South Carolina Why barcode medications? More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516). Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999 Why barcode medications? Nationally 2 of every 100 admissions experienced a preventable adverse drug event, resulting in increased hospital costs of $4,700 per admission. This is $2.8 million annually for a 700-bed teaching hospital. Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999 Where do medication errors occur? Ordering 56% Administration 34% Transcription 6% Dispensing 4% Bates, Cullen, Laird, et al. “Incidence of Adverse Drug Events and Potential Adverse Drug Events.” JAMA, 1995, 274, 29-34. Why barcode medications? *Barcode Medication Administration (BCMA) in VA Medical Centers*: • • • • • Right drug Right dose Right patient Right time Missed meds 75% improvement 62% improvement 93% improvement 87% improvement 70% improvement *Johnson, Carlson, Tucker, & Willette Using BCMA in VA Medical Centers Journal of Healthcare Information Management-Vol 16, No.1 Why barcode medications? *Eastern Kansas Health Care System (VA) 1994-2001*: • 8,000,000 • 549,000 • 0 doses dispensed errors prevented documented errors Why barcode medications? *Eastern Kansas Health Care System (VA) 1994-2001*: • 0 documented errors? On what does this depend? • How do we define “error”? • Doing BCMA the right way Why barcode medications? • How do we define “error”? er·ror failure of a planned action to be completed as intended (an error of execution) or the use of a wrong plan to achieve an aim (an error of planning) • How we define a med error at MUSC? deviation from what the prescriber intended Kohn, Corrigan & Donaldson, “To Err is Human”, Institute of Medicine, 1999 Admin Rx at MUSC Doing BCMA the right way • Will we alter the wrist scanning process for – – – – Isolation patients Emergency Department Surgery NICU, nursery • Details of dispensed medications – Half pill ordered, half pill delivered – Insulin, topicals – IVF with additives How we catch medication errorsa closed loop system: CPOE (Computerized Provider Order Entry) AdminRx eMeds (Pharmacy) Clin Doc