Reinforcement of Barcoding technology in medication delivery process and medication safety education to reduce medication error: A Quality Improvement Project…
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NEED 10 STRATEGIC POINTS ON THE TOPIC FOR THE PROSPECTUS, PROPOSAL ANS DIRECT PRACTICE IMPROVEMENT
PICOT Question: To what degree does the Reinforcement of Barcoding technology in the medication delivery process and medication safety education reduce rate of medication error from 20% to 10% when compared to absence reinforcement among nurses in M&M medical CTR in 4 weeks. A Quantitative analysis.
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Reinforcement of Barcoding technology in medication delivery process: Solution
The 10 Strategic Points
Broad Topic Area:
Using Bar-code technology in the medication delivery process and medication safety education to reduce the rate of medication errors.
Literature Review:
Background of the Problem/Gap:
- Medication errors are closely associated with poor patient outcomes, 1 in 131 outpatient and 1 in 854 inpatient deaths according to IOM, and an increased risk for readmission.
- Bar-coding technology has been adopted to help in the administration of medication of prescribed medication.
- Despite the presence of bar-code technology in the facility, nurses use workarounds that increase the risk of medication errors.
- The challenges associated with the workarounds include an increase in workload, being understaffed, frequent interruptions, lack of adequate education/training on the use of bar-coding technology, and non-compliance with CPOE policy.
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Theoretical Foundations (models and theories to be the foundation for the project):
- Donabedian’s conceptual model was used to evaluate and measure improvements to the quality of care by focusing on the components of the structure, process, and outcomes (Shen et al., 2018).
- The theory of planned behavior (TPB) provided a framework for understanding the individual behavior of nurses and predicted the intention of engaging in a behavior at a specific time and place.
- The Normalization Process Theory provided a framework for implementing, embedding, and integrating the intervention by focusing on human processes that facilitate the adoption of new practices (May et al., 2018).
Review of Literature Topics with Key Themes and Subthemes
Theme 1: Medication administration errors
To understand the problem of medication errors, the research cross-examined the occurrence of medication errors in the clinical setting.
- Causes of medication errors in the unit; examines the potential causes of medication errors, to determine the factors that contribute to the increased risk of medication errors (Bijlsma, & Taxis, 2017; Othman, & Darawad, 2020).
- Prevention of medication administration errors; Researched on the approaches implemented to prevent the occurrence of medication errors and why bar-code technology is among the best frameworks for preventing medication errors (Othman, & Darawad, 2020)
- Safety and quality of care; Examined the link between the cause of medication errors across literature and prevention to determine the correlation with patient safety and quality of care (Van Der Veen et al., 2020; Harrington, Clyne, Fuchs, Hardison, & Johnson, 2013)
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Theme 2: Workarounds in bar-assisted medication administration
Workarounds in bar-coding assisted medication administration are among the critical challenges resulting in high medication error rates. The research included literature examining the nurse workarounds through the themes of;
- Taking short cuts during a work task; examined the factors leading nurses to take short cuts during work tasks involving bar-code assisted technology (Leung et al., 2015).
- Perceived usefulness of bar-assisted medication technology- Researched on the link between the perceived usefulness of barcoded medication technology and workarounds (Harrington, Clyne, Fuchs, Hardison, & Johnson, 2013).
- Role of nursing administration: Focused on the role nurse administration plays in nurse workarounds (Van Der Veen et al., 2018)
Theme 3: Human-machine interface with medication errors
- Nurse level of understanding of Bar-coding technology; the link between the ability to use bar-coding technology and medication errors (Darawad, Othman, & Alosta, 2019).
- Adequacy of bar-coding equipment and information: Examined the presence of supporting material on the use and adoption of bar-coding technology and the potential outcomes (van der Veen et al., 2020).
- Training on the use of bar-coding technology: Focused on the education levels and the impact of training nurses on the use of bar-coding technology on medication administration errors (Booth, Sinclair, Strudwick, Hall, Tong, Loggie, & Chan, 2017).
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Settings:
- Geriatric Psychiatric Unit at M&M medical CTR
Summary
- Gap/Problem: There is a need to implement an evidence-based method to reinforce the use of bar-code technology in medication administration.
- Prior studies: Prior studies show that effective use of bar-code technology in medication administration.
- Quantitative application: Sources of data exist to collect numerical data on the impact of reinforcing the use of bar-coding technology on medication error data in a geriatric facility.
- Significance: Reducing the medication error rates will improve patient safety and quality of care in the geriatric psychiatric facility.
Problem Statement:
While research shows that bar-coding technology is a critical technology in medication administration, It was not known if or to what degree the reinforcement of the use of bar-coding technology in medication administration would impact medication errors when compared to the absence of reinforcing and emphasis on its use among geriatric nurses (population).
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PICOT Questions or Clinical Question:
(P) Among nurses in M&M medical CTR, (I) reinforcement of bar-code technology in the medication delivery process and medication safety education, (C) compared to the absence of reinforcement to reduce medication error rate from (O) 17% to 10%, (T) over a period four weeks?
Clinical Question:
To what degree does the implementation of reinforcement of bar-code technology in the medication delivery process and medication safety education (intervention) impact medication errors when compared to the absence of reinforcement among nurses in M&M medical CTR?
Sample (and Location):
Identify sample, needed sample size, and location (project phenomena with small numbers and variables/groups with large numbers).
- Location: M&M Medical Center, Miami, Florida 33185
- Population (Participants) Hospital-based Nurses
- Sample: 40 RNs
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Inclusion Criteria
- Nurses within the unit handling patients and medication administration.
Exclusion Criteria
- Physicians and nursing managers, not directly involved with medication administration and the use of the bar-code medication system
Define Variables:
- Independent Variable (Intervention): Reinforcement of bar-code medication system
- Dependent Variable: Reduction of medication error rates in the unit
Methodology and Design:
This project will use a quantitative methodology with a meta-analysis design
Purpose Statement:
The purpose of this quantitative, quasi-experimental project was to determine if or to what degree the reinforcement of bar-code medication system among nurses would impact the rates of a medication error when compared to the absence of reinforcement among nurses in a psychiatric unit in a geriatric facility in Arizona over four weeks.
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Data Collection Approach:
To collect data from nurses, Harrington Bar-Code Medication Administration Evidence-Based Checklist tool was used pre-intervention and post intervention to determine the nurses’ compliance with bar-code medication administration. Documenting clinical records on the number of medication errors in the facility throughout the four weeks of intervention
Data Analysis Approach:
Descriptive statistics will describe the sample characteristics and variable results. Mean, and the standard deviation was used to examine nurse compliance with Bar-code medication systems. Spearman correlation test was used to identify correlations between compliance and satisfaction with the BMCA system, perceived usefulness, training and understanding of the systems, and ease of use and the medication error rates in the facility.
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References
- Bijlsma, M., & Taxis, K. (2017). Association between Workarounds and Medication Administration Errors in Bar Code-Assisted Medication Administration: Protocol of a Multicenter Study. JMIR research protocols, 6(4), e74-e74.
- Booth, R. G., Sinclair, B., Strudwick, G., Hall, J., Tong, J., Loggie, B., & Chan, R. (2017). Strategies through clinical simulation to support nursing students and their learning of Barcode Medication Administration (BCMA) and Electronic Medication Administration Record (eMAR) technologies. In Health Professionals’ Education in the Age of Clinical Information Systems, Mobile Computing and Social Networks (pp. 245-266). Academic Press.
- Darawad, M. W., Othman, E. H., & Alosta, M. R. (2019). Nurses’ satisfaction with bar-code medication‐administration technology: Results of a cross‐sectional study. Nursing & Health Sciences, 21(4), 461-469.
- Harrington, L., Clyne, K., Fuchs, M. A., Hardison, V., & Johnson, C. (2013). Evaluation of the use of bar-code medication administration in nursing practice using an evidence-based checklist. JONA: The Journal of Nursing Administration, 43(11), 611-617.
- Leung, A. A., Denham, C. R., Gandhi, T. K., Bane, A., Churchill, W. W., Bates, D. W., & Poon, E. G. (2015). A safe practice standard for bar-code technology. Journal of patient safety, 11(2), 89-99.
- As you continue, nursingstudy.org has the top and most qualified writers to help with any of your assignments including how to manage stress in workplaces. All you need to do is place an order with us (Reinforcement of Barcoding technology in medication delivery process and medication safety education to reduce medication error: A Quality Improvement Project.).
- May, C. R., Cummings, A., Girling, M., Bracher, M., Mair, F. S., May, C. M., & Finch, T. (2018). Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review. Implementation Science, 13(1), 80.
- Othman, E. H., & Darawad, M. W. (2020). Nurses’ Compliance with Bar-code Medication Administration Technology: Results of Direct Observation of Jordanian Nurses’ Practice. CIN: Computers, Informatics, Nursing, 38(5), 256-262.
- Shen, M., Chen, S., Liu, X., GAO, J., Xiaohua, W. U., Hongzhen, X. U., & Zhu, J. (2018). Establishment of evaluation pediatrics nursing-sensitive quality indicatorssystembasedon Donabedian’s structure-process-outcome theory. Chinese Journal of Practical Nursing, 34(26), 2035-2041.
- Van der Veen, W., Taxis, K., Wouters, H., Vermeulen, H., Bates, D. W., van den Bemt, P. M., & Vasbinder, E. C. (2020). Factors associated with workarounds in barcode‐assisted medication administration in hospitals. Journal of Clinical Nursing.
- Van Der Veen, W., Van Den Bemt, P. M., Wouters, H., Bates, D. W., Twisk, J. W., De Gier, J. J., … & Ros, J. J. (2018). Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals. Journal of the American Medical Informatics Association, 25(4), 385-392.
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