Scanning for Safety

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Ensuring the smallest, most vulnerable patients are exposed to the least risk for an adverse outcome is the goal of Credit Valley’s award-winning electronic medication administration record and bedside medication verification project (eMAR/BMV).

Since medication errors are the leading cause of preventable adverse drug events in health care, The Credit Valley Hospital’s safer heath-care measures, implemented at the bedside, ensure the right patient gets the right dose, of the right medication, in the right way, at the right time.

The bar-coding system was recently recognized by the Ontario Hospital Association with a leading practice award. In fact, The Credit Valley Hospital is the first hospital in Canada to implement bar coding within a neonatal special care nursery (SCN).

The award-winning technology ensures positive patient identification before medication is administered. Data is scanned and registered on a computer tablet at the bedside, becoming part of the patient’s electronic health record in real time. As soon as the information is uploaded, it can be accessed by heath-care providers throughout the hospital to assist in clinical decision-making.

The technology generates warnings at the bedside when it encounters a discrepancy in the ideal administration process for medication, alerting the care provider to a potential for error before it occurs. During the implementation phase of the technology, major warnings were detected in 1.09 per cent of medication administrations which, although a low percentage, is still a significant consideration in the provision of the safest health care for our newborns.

Jill Wright, a nurse in the special care nursery, says the computer interface is a user-friendly one that provides an essential link for the whole team – from physicians to nurses, pharmacists, dietitians, respirologists and other team members. “We’re all working from the same information generated by the computer software, so that once it is uploaded to the bedside, it supports our work, ensuring the right medication is administered to the right newborn according to the dosage and timing displayed on their computer screen,” Wright says.

“Before medicating the newborn, the vial’s bar code is scanned into the health record. Then, the baby’s bar coded ankle-bracelet is scanned to ensure a match according to the physician orders for that particular newborn. If the dose is incorrect or the timing is not correct or the medication is being administered to the wrong newborn, an alert is generated, preventing the possibility of a potential medication administration error,” she says.

In a busy nursery where situations such as multiple births and thus two to three and even four or five newborns with the same surname might present the opportunity for error, you can appreciate the value of technology that provides the safety net that this kind of verification provides. “The electronic medical administration record is an extra step but it’s a valuable one that supports the safest care we can provide our neonates,” says Wright.

The system accomplishes improved patient safety for the most vulnerable of patients – our newborns. Credit Valley’s staff care for level two-plus neonates – newborns covering the spectrum of care from jaundice to those with a more complicated diagnosis such as short-term intubation. The technology is a tool recognized by nursing and physicians as a valuable supplement to facilitating communication between team members.

“The award from the Ontario Hospital Association is another recognition of the value this technology offers to improve communication around patient care for safe patient outcomes,” says Kathryn Hayward-Murray, Credit Valley’s vice president strategy, quality and organizational performance and chief nursing executive. “The neo-natal bar coding system ensures we can provide the safest and best possible care,” she says.