Bar-code verification technology, widely used outside of healthcare, may reduce medication transcription and administration errors and potential adverse drug events. In the 6 May 2010 issue of the New England Journal of Medicine, Poon et al. reported a 27.3% fall in timing errors in medication administration (administrations that were early or late by more than one hour), but the rate of potential adverse drug events related to timing errors did not change significantly. On the other hand, the researchers found a 41.4% reduction in non-timing errors, and a 50.8% fall in the rate of potential adverse drug events (associated with non-timing errors). Transcription errors occurred at a rate of 6.1% on patient care units that did not use the bar-code electronic medication-administration system but were completely eliminated on units that used it.
The researchers acknowledged some limitations of their study:
- It was conducted in a hospital which already had computerised physician-order entry for physicians and bar-code verification for pharmacy staff. Hospitals without one or both of these technologies pre-installed may find different effects on administration errors.
- Potential adverse drug events were examined, not actual adverse drug events, although there appears to be some correlation between the two.
- Key staff provided considerable support for changes in the medication delivery workflow, something which might not be replicable elsewhere.
- Significant resources, including training and on-site support, were required.
- Possible Hawthorne effect, i.e. the nurses observed in the study might have performed better by virtue of being observed.
- Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, Moniz T, Rothschild JM, Kachalia AB, Hayes J, Churchill WW, Lipsitz S, Whittemore AD, Bates DW, Gandhi TK. Effect of bar-code technology on the safety of medication administration. N Engl J Med 2010;362:1698-1707.