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Barcode Medication Administration (BCMA) . Presented By: Amrita Singh Keneikhrienuo. Contents . What is BCMA?. Electronic software application Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computer
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Barcode Medication Administration (BCMA) Presented By: Amrita Singh Keneikhrienuo
What is BCMA? • Electronic software application • Combines barcode technologies with real-time Ethernet local area network (LAN) that connects with a centralized computer • First developed 1995 VA Medical Center Topeka, Kansas • Introduced nationwide in 2000 (Wideman, Whittler, & Anderson, n.d.)
BCMA Basic Steps • Physician order received • Order faxed to Pharmacy • Pharmacists edit and verify electronic orders into patient profile • Pharmacy dispenses ordered medications in Bar-Coded packages • Nurse accesses BMCA software on computer via log on • Nurse scans unique patient bar-coded ID band
Hardware Model • Wireless PC • BCMA • Scanner • Barcodes • Keyboard
Barcode Scanning Device • Light weight and comfortable hand held design • Built in decoder • Emits high intensity red aiming beam • Trigger button
Software • Siemens Med Administration Check (MAC) • Siemens Pharmacy • INVISION • Chart-Assist • Interface with LCR and PYXIS Connect ( Siemens 2005)
Software MAC • MAC is a nursing application • Database collects, sorts, organizes, and stores information • Database allows nurse to easily retrieve select and aggregate data • Open MAC application using login id and password • Select patient from database • All patients information is stored on database
Standards • When multiple parties or companies are involved in the ID process, industry standards are usually established • The standard is not necessarily the same as the barcode symbology • Barcode standards define how to use the barcode symbology in a particular situation • ISBN is a standard for labeling books • Periodicals that uses the EAN-13 symbology
Usability • User friendly • Easily learned • Overall department satisfaction with use • Access information easily • Interface achieves particular goals • Error tolerance
Advantages • Improves medication administration flow with online work list • Checks for five rights at the point of care with bar code technology • Drives online MAR documentation, charging, inventory control • Uses proven point of care technology options • Is designed for acute, ambulatory, long term care environment
Advantages • Provides value added clinical and operation integration • Can include assessment and process redesign consulting services • Compatible with any automated drug dispensing device and drug wholesaler • Assesses for pain by prompting a pain scale when administering analgesics
Disadvantages • Not foolproof • Bar codes mismatch with drug, dose, and patient at times • Bar code sometimes function erroneously • Unable to scan bar codes properly at times • Duplicate patient identification bar codes have been scanned for multiple patients
Disadvantages • Carrying several patients pre-scanned medications on one tray • Disabling system alarms to avoid disturbing their patients • Unreadable bar codes • Emergency Situations • Time consuming
Ethical/Legal Issues • Potential problems in regards to HIPPA • Leaving the computer in the hallway with patient name and identity exposed • Nurses not logging off the software application • Unethical/ethical in regards to overrides
Competencies • Clinicians have various technological backgrounds • Users were accessible to staff every shift 24 hours • Workshops are initiated • Need successful completion of the course
Competencies • Staff representatives include inpatient pharmacist, ICU nurse, ward nurse, and a nursing instructor • Ongoing refresher courses offered • Job shadowing • Multidisciplinary cross training techniques increase staff understanding and competency
Conclusion • Technology at work at the bedside • Increasing safety • Increasing continuity of care • Increasing satisfaction among staff • Increasing communication
Functions & Responsibilities of Informatics Nurses working with BMCA • Incorporate theories, principles, and concepts from appropriate sciences and evidence based practice • Integrate ergonomics and human-computer interaction principles appropriately and efficiently • Systematically determine the social, legal, and ethical impact and play an active role in system improvement (McGonigle & Mastrian, 2009)
Conclusion • Decreases medication errors • Decreases law suits • Regardless of some small disadvantages the application can be improved over time • Opens new windows and doors for communication and safety
References • Technology for Long Term Care. (2008). Barcode Medication Administration. Retrieved February 15, 2009, from Technology for Long term Care Web site: http://www.techforltc.org • McGonigle, D., & Mastrian, K. (Eds.). (2009). Nursing Informatics and the Foundation of Knowledge. Mississauga, Ontario Canada: Jones and Bartlett.