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Michael E. DeBakey VA Medical Center - Houston, Texas

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How Supermarket-Scanning Technology is Used to Prevent Medication Errors at the Houston VA

September 10, 2002

How Supermarket-Scanning Technology is Used to Prevent Medication Errors at the Houston VA

The BCMA process has drastically reduced medication errors in Veterans Affairs hospitals nationwide.
by Jean L. Uy, RN, MSN, CCRN, CNS-CC, Education Service Line

Released: 2002/09/10

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Photo by Shawn James, HVAMC Media Section

Using a hand-held scanner to read the bar-coded, identification wristband of veteran, Willie R. Hutcherson, Jeffery Dubea, LVN, ensures Mr. Hutcherson receives the correct medication in the correct dose at the correct time. VA's Bar Code Medication Administration is a program designed to eliminate medication errors like poor handwriting and lost paper prescriptions. If the physician cancels or changes a drug order mid-shift, the system catches the change and prevents administration of the wrong dose.

HOUSTON, TX - Two years ago, the Veterans Health Administration (VHA) initiated a groundbreaking step towards improving patient safety. The initiative was the introduction of the Bar Code Medication Administration (BCMA) process.

Administering medications, a significant component of delivering quality care, is a complex process, and previously, primarily paper-based. A breakdown at any step along the way could compromise patient safety.

The BCMA process consists of using a scanner, very similar to the device we see in supermarkets, to scan a patient's hospital identification (ID) band, and then scan the medications the patient is supposed to receive. This allows a nurse or other health care provider to make sure that a veteran is receiving the correct medication in the correct dose at the correct time.

The system starts when each patient entering the Houston VA Medical Center (HVAMC) is given a specialized bar-coded wristband that can transmit their relevant identifying information to the hospital computer. The next step involves a physician entering a medication order for a veteran into the computer. Technicians in the HVAMC pharmacy double-check the order and process it. The pharmacy then sends the medication to the nursing unit where the patient is receiving care. This is where a HVAMC health care provider will again verify the order, using real-time information, before finally administering the medication to his or her patient.

Many veterans, who have been hospitalized at the HVAMC in the past two years, may have noticed the carts that nurses push along the hallways. There is a laptop computer and a scanner on the top of each of these medication carts.

When a nurse comes to your room and scans your ID band, the Bar Code Medication Administration (BCMA) process is being used. This procedure has drastically reduced medication errors in every Veterans Affairs (VA) hospital.

Furthermore, VA is the first health care agency to use bar codes nationwide. Many private hospitals across the country have now followed suit.

The first version of BCMA did not incorporate all the essential steps for dispensing medications. The first version did not allow health care providers to enter orders for intravenous solutions and drips. This restricted the systems usefulness in the intensive care units (ICUs).

The creators of BCMA and the members of the VA taskforce assigned to work on this project, realized these restrictions and worked to improve and enhance the system. They listened to the recommendations of pharmacists, doctors, and nurses.

The result? The HVAMC will begin using Version #2 of BCMA by November 2002. Version #2 will allow point-of-care in high-risk ICU situations.

Thanks to the BCMA system, the VHA has improved patient safety by giving nurses access to the most up-to-date medical information available; thereby, increasing the accuracy of medication administration.

Veterans, and VA employees alike, should be very proud of what the Department of Veterans Affairs is trying to achieve. Our veterans belong to a health care system that is extremely innovative, and on the frontline of research and technology. Most importantly, we place the safety of our veterans first.

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Point of Contact: VHAHOU Public Affairs

04/21/04 08:25