Barcodes prevent medicines mishaps

By BRETT DUNLAP, Staff Writer


PARKERSBURG — With more types of medicines available, local hospitals are utilizing barcode technology to help make sure patients are getting the proper medication.

Over the past few years, both St. Joseph’s Hospital and Camden-Clark Memorial Hospital have implemented systems where medications are barcoded and entered into a computer. The patients also have a barcode on their identification bracelets which ties into a computer system where doctors are able to assign out their medications.

Through these systems, nurses are able to scan a patient’s barcode and know what medications they have been prescribed and when they need to be given. The nurse then scans the barcode on the medication to verify it is the proper medication for an individual patient. If not, each system will issue a warning and will not allow the nurse to continue until the error has been rectified.

The St. Joseph’s system is referred to as the Electronic Medication Administration Record (or eMAR) while the Camden-Clark system is called the Bedside Medicine Verification System.

Patients getting the proper medications had reentered the news lately after the twin children of actor Dennis Quaid were put at risk after being given an accidental overdose the anti-coagulant drug Heparin, which stops the blood from clotting, while at Los Angeles’ Cedars Sinai Medical Center. Problems with the labeling of the vials the drug came in are being blamed in the mix-up.

Kent Kloes, Director of Pharmaceutical Services at St. Joseph’s Hospital, said medications are now required to be barcoded and pharmacies now do their own packaging and barcoding when the products come in before the product is put out in the automated dispensing machines on the various floors.

‘‘About 98 to 99 percent range has a barcode on it,’’ Kloes said. ‘‘Barcodes definitively identify a product. That barcoding actually helps us make sure it matches what the patient is suppose to receive.’’

The system works to provide patient safety and a double check for the nursing staff, he said.

As patients undergo tests, the results are made available through the eMAR system, allowing doctors to review them quicker and to make any needed adjustments in medications and made available to the nursing staff on the floor, said Brenda Thompson, Registered Nurse and Risk Manager at St. Joseph’s Hospital.

In the past, it was the human being checking what it was they were giving the patient, said Deidre Ruble, staff pharmacist at Camden-Clark. Better communications and alerts that other facilities have helped them keep track of potential problems, she added.

‘‘The biggest thing we have implemented is the use of bar code technology so you just don’t rely on the human being to read everything they are giving,’’ Ruble said. ‘‘We are using the barcode scanning at every point (from labeling the medications when they first come in to putting them into distributing machines).’’

By scanning the wristband of the patient, the nurse has a computer record of that patient and what medications they are suppose to get.

‘‘They still ask the questions they use to ask to verbally make sure they have the right patient, but they also scan the wristband now,’’ Ruble said. ‘‘That matches with their orders that are in the computer. The nurses then scan each medicine before they give it and if they have something that doesn’t match, it stops them.’’

If they believe they have fixed the problem and the system still won’t let them continue, the nurse will then call the pharmacy department to troubleshoot the problem to see where the problem is, she said. In most cases, the nurse will send the medication in question back to the pharmacy to be replaced.

Once the medication is barcoded, it is checked and verified again by the staff to make sure the right barcode was put on the right medication, Ruble said.

The whole Bedside Medicine Verification System has really improved safety, said Kerry Cottrell, Nursing and Informatics Analysist for Camden-Clark.

The system helps the nursing staff meet five basic criteria in distributing medication, she said. Those include making sure they have the right patient, making sure they have the right medications, giving the proper dosage, making sure they are giving it in the right form (whether injection or oral) and at the right frequency (if a patient is suppose to get a certain number of doses in a day).

Ruble said people get busy and something can easily be overlooked.

‘‘This system has caught some mistakes that could have been made,’’ she said. ‘‘It is just a check on the human being who is busy and can be distracted.’’

Debbie Kinsolving, Registered Nurse and Clinical Coordinator of Obstetrical Services at St. Joseph’s Hospital said the eMAR system has helped the nursing staff.

‘‘The nurses like it because we have 10 different things backing us up,’’ she said. ‘‘We no longer just go pull a medication, go to the bedside to give it. We have all the safety checks involved. In the long run it has made our lives easier.’’

Lynn Orhn, Registered Nurse and Clinical Coordinator for Pediatric Services at St. Joseph’s Hospital, said the system also creates a complete record of when medications were given and how much was given.

‘‘It automatically documents everything as you are going through the process,’’ she said. ‘‘The patients really seem to like it. They feel safer with it.’’

It has helped eliminate some incorrect billings on medications, officials said.

One of the biggest concerns patients have today is getting the wrong medications, Kloes said.

A lot of that has to do with the public being more informed about what is available, Kinsolving said.

‘‘The public is more aware now,’’ she said. ‘‘About 20 years ago when I had surgery, you never questioned a physician about what they were doing or what you were getting.

‘‘They brought it in, set it down and you took it. Today, patients know what they are taking and they know why they should be getting it or why they shouldn’t be.’’

Kloes said the computer helps check everything but it will never replace the people who provide the care.

‘‘(The eMAR) makes the patient feel safer,’’ he said. ‘‘It makes the staff feel more secure that what we are doing is correct because we have a computerized system that is confirming what we do.

‘‘However, the computer does not replace the clinical judgment of anyone in the system. Computers are wonderful, but situations do not always follow patterns exactly so the clinical judgment of our nursing staff on the front lines is still the most paramount decision.’’

Contact Brett Dunlap at bdunlap@newsandsentinel.com