Improving Bar Code Medication Administration in Limited Stay Facilities

The Institute for Safe Medication Practices (ISMP) has introduced a new best practice for the 2022-2023 Targeted Medication Safety Practices for Hospitals that recommends expanding bar code medication administration (BCMA) use beyond inpatient spaces into areas with limited or short patient stays, such as oncology infusion centers.

Following a compliance check of a large health system, 10 oncology infusion centers were found to not meet the scan rate goal. A poster presented by Kayla Cierniak, PharmD, BCPS, FISMP, MS, of the Seidman Cancer Center in Lakewood, Ohio, at the American Society of Health-SystemPharmacists 2022 Summer Meetings and Exhibition in Phoenix, Arizona, evaluated achievement of a 1-year BCMA compliance goal.

The current goal for BCMA compliance isgreater than 95%. To achieve this, multiple improvement interventions were implemented: Nurse managers were given educational classes, guidance documentation, and individual coaching, as well as confirmed access to unit-specific for bar code medication administration data;review tutorials and open forums were offered on-demand to nurse managers for 2 months; and a job aid, showing how to review the data, was created by the medication safety office and then distributed to the centers.

In January 2021, the average scan rate at oncology infusion centers was 78%. By December 2021, the scan rate had increased to 96%. All centers showed improvement over the course of a year in their compliance, and 9 centers were able to achieve the goal of more than 95%.

The initiative highlighted challenges and barriers for appropriate use: Bar code medication administration cannot replace visual inspection to ensure that the correct medication has been scanned. At 1 site, a misconception was identified in which staff believed that only chemotherapy agents—not premedications such as dexamethasone—required scanning. Additionally, when staffing is loss to attrition, unit-specific access to the data along with review and interpretation are not handed off.

Investigators concluded that BCMA compliance was able to be improved over the course of year with strategies that were both simple and low-cost. Ongoing education and support for compliance review are necessary, particularly during turnover in management.

Reference

Cierniak K. Bar code medication administration (BCMA) one year processimprovement initiative in a multi-site hospital ambulatory oncologyinfusion service. Presented at:American Society of Health System Pharmacists 2022 Summer Meetings and Exhibition; June 11-15, 2022; Phoenix, AZ. Poster 35-M.