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CIN: Computers, Informatics, Nursing:
doi: 10.1097/NCN.0b013e31821635e4
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Scanning for Safety: An Integrated Approach to Improved Bar-Code Medication Administration

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GENERAL PURPOSE STATEMENT: To familiarize the nurse with an improvement project aimed at improving bar-code medication administration (BCMA).

LEARNING OBJECTIVES: After reading this article and taking this test, the nurse will be able to:

1. Define the BCMA improvement project.

2. Describe the analysis of the project data.

1. Prescribing and administration account for about what percentage of medication errors?

a. 50%

b. 60%

c. 70%

d. 80%

2. The improvement project discussed in this article was begun after a root-cause analysis of which safety feature of the BCMA system?

a. scanner technology

b. overrides

c. employee ID badges

d. patient wrist bands

3. An error message that alerts the provider about a medication error, but the provider administers the medication despite the warning is known as

a. an override.

b. an option.

c. missed event.

d. safeguard.

4. The plan presented in this article focused on all except

a. products.

b. implementation.

c. technology.

d. education.

5. Which was identified as a reason for overrides?

a. bar-code issues

b. patient issues

c. internal process problems

d. educational problems

6. The largest numbers of overrides were found to be related to

a. equipment or personnel factors.

b. pharmacy label issues.

c. insulin administration.

d. pain medication administration.

7. Which best describes an internal process problem?

a. aging scanners

b. noncompliance

c. multiple bar codes

d. medication-packaging issues

8. A major equipment issue identified was

a. the use of tethered scanners.

b. incompatibility with the network.

c. wireless network connectivity.

d. malfunctioning batteries.

9. Which is an acceptable override reason category?

a. scheduled event

b. emergent event

c. patient out of the room

d. patient testing

10. Hospital-level analysis projected that the facility could reduce overrides to how many per month?

a. 1000

b. 3000

c. 6000

d. 9000

11. The most significant improvement was noted after implementation of a thermal label printer and

a. upgrading the wireless system.

b. replacing the scanners.

c. mandatory education.

d. second verification.

12. Which of the following showed significant improvement based on analysis at the unit level?

a. override compliance

b. identification compliance

c. override documentation

d. doses charted

13. Units that had the highest override compliance rates had limited

a. insulin orders.

b. pain medication orders.

c. PO medications.

d. IV medications.

14. Provider-level analysis found that who was responsible for a statistically significant number of overrides for the individual unit?

a. one staff person

b. the unit manager

c. the evening staff

d. the night staff

15. One study found that medication errors contributed to an increased length of stay of

a. 2.3 days.

b. 3.1 days.

c. 4.6 days.

d. 6.2 days.

16. According to the authors, which challenges limited the success of the BCMA project?

a. administrative

b. educational

c. personnel

d. workflow

17. Overall, the BCMA project reduced the cost related to medication errors by more than

a. $500,000.

b. $1.8 million.

c. $2.8 million.

d. $5 million.

18. According to the authors, improvement was achieved when the multidisciplinary team focused on

a. BMCA.

b. unit compliance.

c. staff education.

d. patient outcomes.

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