Using Barcode Technology to Improve Medication Safety
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|ClinicalTrials.gov Identifier: NCT00243373|
Recruitment Status : Completed
First Posted : October 24, 2005
Last Update Posted : January 19, 2012
|Condition or disease||Intervention/treatment||Phase|
|Impact of Barcode Technology on Medication Errors||Device: Barcode technology/eMAR||Not Applicable|
Patient safety is a critical issue in healthcare1. Medications are the most commonly used form of medical therapy and the single most frequent cause of adverse events2. The medication use process has several stages: ordering, transcribing, dispensing, administering and monitoring. Medication errors have been shown to be common3,4, and a large proportion (61%) of them occur in the dispensing, transcribing and administering stages5. Barcode technology in conjunction with an electronic medication administration record (eMAR) system has been proposed as a promising way to reduce medication errors at the transcribing, dispensing, and administering stages6. However, its efficacy for reducing medication error rates, its acceptance by staff, and its cost-benefit ratio remain unknown. Without evidence to clarify these issues, it is difficult for health care organizations to prioritize this technology among many other potential safety interventions7. We therefore propose to answer 3 related questions in this study: i) What is the impact of barcode and electronic medication administration record (barcode/eMAR) technology on reducing medication errors in hospitalized patients? ii) What is the impact of barcode/eMAR technology on nursing and pharmacy efficiency and satisfaction? iii) Can the cost of barcode/eMAR technology be justified by its benefits? We propose to address these questions at the Brigham and Women's Hospital (BWH), which has a long-standing tradition of innovation in healthcare and research in medication safety. In particular, it was one of the first hospitals to assess the impact of computerized physician order entry (CPOE) on medication safety8,9. While CPOE is important for improving medication safety, it addresses errors primarily in the ordering stage of the medication use process, leaving patients vulnerable to errors that occur at the dispensing, transcribing and administering stages. Therefore, as part of a multi-disciplinary patient safety initiative, BWH has committed 3 million dollars to build a state-of-the-art barcode/eMAR system. This system will include sophisticated decision support to reduce medication errors made beyond the physician ordering stage. Design work is near completion and the hospital plans to implement the system in phases over 9 months beginning in the 4th quarter of 2003. This offers us a window of opportunity to formally study the broad impact of barcode/eMAR technology. We propose to perform a prospective, controlled, multidisciplinary randomized controlled trial of barcode/eMAR's impact on medication errors, as well as evaluations of impact on hospital efficiency, staff satisfaction, and hospital finances.
We plan to address the following 3 specific aims over the proposed 24 months of the study:
- To evaluate the impact of barcode/eMAR technology on the rate of serious medication transcribing and administration errors.
- To evaluate the impact of barcode/eMAR technology on nursing workflow and satisfaction in an acute care hospital.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||6700 participants|
|Intervention Model:||Crossover Assignment|
|Masking:||None (Open Label)|
|Official Title:||Using Barcode Technology to Improve Medication Safety|
|Study Start Date :||April 2005|
|Actual Primary Completion Date :||December 2005|
|Actual Study Completion Date :||March 2008|
- Transcription errors
- Administration errors
- Serious medication errors
- Nursing satisfaction
- % nursing time spent on medication administration
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00243373
|United States, Massachusetts|
|Brigham and Women's Hospital|
|Boston, Massachusetts, United States, 02115|
|Principal Investigator:||Tejal Gandhi, MD||Brigham and Women's Hospital|