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Challenges Implementing Bar-Coded Medication Administration in the Emergency Room in Comparison to Medical Surgical Units


CIN: Computers, Informatics, Nursing: March 2013 - Volume 31 - Issue 3 - p 133–141
doi: 10.1097/NXN.0b013e318280ef5e

Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. Many factors negatively impacted utilization in the emergency department, including the inability to use bar-coded medication administration for verbal orders or to document medications distributed by the prescribing providers, unique aspects of emergency department nursing workflow, additional steps to chart when using bar-coded medication administration, and alert fatigue. Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability.

Author Affiliation: Information Services, Maine Medical Center, Portland.

The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Nancy Glover, MS, BSN, RN, Information Services, Maine Medical Center, 420 Cumberland Ave, Portland, ME 04101 (;

© 2013 Lippincott Williams & Wilkins, Inc.