eprintid: 10204088
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/20/40/88
datestamp: 2025-01-29 15:08:03
lastmod: 2025-01-29 15:08:03
status_changed: 2025-01-29 15:08:03
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Williams, Rachel
creators_name: Kantilal, Kumud
creators_name: Man, Kenneth KC
creators_name: Blandford, Ann
creators_name: Jani, Yogini
title: Barcode medication administration system use and safety implications: a data-driven longitudinal study supported by clinical observation
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: C08
divisions: DF9
divisions: D10
divisions: D12
divisions: G11
divisions: G20
keywords: Electronic Health Records, Health Services Research, Medical Informatics, Humans, Longitudinal Studies, Medication Systems, Hospital, Medication Errors, Electronic Data Processing, Retrospective Studies, Patient Safety
note: Copyright © Author(s) (or their
employer(s)) 2025. Re-use
permitted under CC BY-NC.
No
commercial re-use.
See rights
and permissions. Published by
BMJ Group. See: https://creativecommons.org/licenses/by-nc/4.0/deed.en
abstract: OBJECTIVES: Barcode medication administration (BCMA) systems may improve patient safety with successful integration and use. This study aimed to explore the barriers and enablers for the successful use of a BCMA system by examining the patterns of medication and patient scanning over time and potential safety implications. METHODS: Retrospective longitudinal study informed by prospective clinical observations using data extracted from five hospital wards over the first 16 months after implementation to determine trends in medication and patient scanning rates, reasons for non-compliance and scanning mismatch alerts. Regression models were applied to explore factors influencing medication scanning rates across wards of different specialties. RESULTS: Electronic data on 613 868 medication administrations showed overall medication scanning rates per ward ranged from 5.6% to 67% and patient scanning rates from 4.6% to 89%. Reported reasons for not scanning medications were 'barcode not readable' and 'unavailability of scanners'. Scanning rates declined over time and the pattern of reason codes for not scanning also changed. Factors associated with higher scanning rates included a locally led quality improvement (QI) initiative, the medication administration time and the medication formulation, for example, tablets and liquids. Overall, 37% of scanning alerts resulted in a change in user action. Staff tried to comply with the BCMA system workflow, but workarounds were observed. DISCUSSION: Compliance with BCMA systems varied across wards and changed over time. QI initiatives hold promise to ensure sustained use of BCMA systems. CONCLUSIONS: BCMA systems may help to improve medication safety, but further research is needed to confirm sustained safety benefits.
date: 2025-01-19
date_type: published
publisher: BMJ
official_url: https://doi.org/10.1136/bmjhci-2024-101214
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2355925
doi: 10.1136/bmjhci-2024-101214
medium: Electronic
pii: bmjhci-2024-101214
lyricists_name: Man, Keng
lyricists_name: Jani, Yogini
lyricists_name: Williams, Rachel
lyricists_name: Kantilal, Kumud
lyricists_id: KCKMA73
lyricists_id: YHJAN61
lyricists_id: RWILA62
lyricists_id: KKANT68
actors_name: Kantilal, Kumud
actors_id: KKANT68
actors_role: owner
funding_acknowledgements: Not applicable [UCLH Charity]; Not applicable [University College London Hospitals NHS Foundation Trust]
full_text_status: public
publication: BMJ Health Care Informatics
volume: 32
number: 1
article_number: e101214
event_location: England
citation:        Williams, Rachel;    Kantilal, Kumud;    Man, Kenneth KC;    Blandford, Ann;    Jani, Yogini;      (2025)    Barcode medication administration system use and safety implications: a data-driven longitudinal study supported by clinical observation.                   BMJ Health Care Informatics , 32  (1)    , Article e101214.  10.1136/bmjhci-2024-101214 <https://doi.org/10.1136/bmjhci-2024-101214>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10204088/1/Kantilal_e101214.full.pdf