Coding and Printing : Hospital Links Coding and Labeling
A recent hospital study that utilized thermal-transfer printer technology along with drug coding and wristband labeling resulted in a healthy reduction in medication dispensing errors.
Administrators at Beloit Memorial Hospital, a 175-bed community hospital located in Beloit, WI, kicked off the pilot study in late 2003 in a bid to see if introducing technology tools at the point of care would reduce the risk for medication administration error. After internal process-mapping analysis, Beloit’s management instead chose to introduce bar coding, deciding it would be more cost-efficient, easier to deploy, and ultimately more effective in preventing errors.
When the study began, only 35% of medications entering the hospital’s pharmacy were bar coded at the unit-of-use level. Managers then decided to have all medications bar coded, repackaging those drugs that did not have codes.
The entire inventory of the hospital pharmacy department was converted to items that came with bar codes from the manufacturer on each dose, or bulk items that could be unit-dose-packaged with a bar code by the pharmacy. Staff at the pharmacy then applied labels printed with the National Drug Code (NDC) symbology, using on-demand thermal printers from Zebra Technologies Corp. (Vernon Hills, IL), a provider of thermal-transfer printers. Zebra printers were used to create on-demand bar code medication management labels in the pharmacy for bulk multidose items, according to Doris Mulder, RN, vice president of nursing at the hospital. “The printers were used to print bar codes attached to the medications for scanning at the point of care, and to print patient-specific labels for medications. We had to repackage and relabel about 40% of our medications,” she says.
Soon after this part of the project, the hospital’s nursing staff began using handheld scanning devices at the bedside level. According to Mulder, about 60 nurses were equipped with lightweight handheld computers that contained integrated bar code readers. Nurses were then able to confirm a patient’s identity by scanning the bar code wristband. After reviewing the list of medications ordered on the computer’s screen, the nurses scanned the medication to confirm the dosage and scheduling. “Using bar coding at the point of care for medication administration, we have seen over an 80% decrease in reported medication errors,” reports Mulder.
Now that the study has been completed, Beloit Memorial continues to use bar coding in all of its inpatient units for bedside administration of medication, she says, adding that she has seen a decrease in reported errors in every unit.