Nursing Bar code medication administration (BCMA) is one of the keys to minimizing medical errors in a manner consistent with evidence-based practice (Poon et al., 2010). However, universal embrace and utilization of BCMA remains stagnant. Reasons for resisting the transition to BCMA include nurse perceptions. Holden, Brown, Scanlon, & Tzion-Karsh (2012), for instance, found nurses reporting low perceived usefulness of BCMA in spite of the wealth of evidence supporting the technology. Perceived ease of use of BCMA was moderate, suggesting that it is mainly attitude factors preventing nurses from implementing BCMA in their institutions. When perceptions of the usefulness of BCMA increase, then compliance with BCMA standards can become more widespread. Any program that attempts to increase the utilization of BCMA must focus first on human factors including attitudes. This requires that all nurse leaders, as well as nurse educators, prepare advance practice nurses for using BCMA as a matter of course. Nurse educators are responsible for ingraining early the need for BCMA based on evidence, and creating a normative culture for its use in practice. Nurse leaders likewise have a duty to socialize new nursing staff in the use of BCMA, with special attention paid to staff with seniority who may not be familiar with or interested in the technology. Special training in BCMA may therefore...
Patterson, Rogers, Chapman & Render (2006) also point out the significance of the technology itself, improving ease of use and access to nurse training programs. It is critical to reduce noncompliance, and nurse managers may need to resort to punitive measures with staff who are using workaround strategies to avoid BCMA.
Lewin model of change can be useful as a way of encouraging people to get motivated about changing an ingrained policy that is no longer serving the organization. The first, foundational step of the model is the need to 'unfreeze' current standard operating procedures and to convince workers of the need for change. In the scenario you described, it seems as though there was a base level of understanding
Quality and Safety Gap AnalysisIntroductionThe provision of safe, high-quality patient care is critical in healthcare organizations. However, systemic problems in healthcare systems have contributed to adverse quality and safety outcomes. The purpose of this paper is to identify a systemic problem in a healthcare organization, propose specific practice changes that will improve quality and safety outcomes, prioritize proposed practice changes, determine how proposed practice changes will foster a culture of
Executive SummaryThe systemic problem identified in this gap analysis is medication errors in a hospital setting, which contribute to adverse patient outcomes, including hospitalization, disability, and even death. To address this issue, several practice changes have been proposed, including the implementation of Bar Code Medication Administration (BCMA), use of Electronic Prescribing Systems (EPS), medication reconciliation, nursing education and training, and improved communication and collaboration among healthcare providers.Key Quality and Safety
Compendium to Research in Cardiology and Telemetry Cotiga, D., et al. (2007). Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation. Pacing & Clinical Electrophysiology, 30(12), 1527-1530. doi:10.1111/j.1540-8159.2007.00902.x. The researchers look at the role of Dofetilide (D) as "a highly selective blocker of the rapid component of the delayed rectifier potassium current;" approved for the treatment of atrial fibrillation (AF). The study is a replication of clinical trials that concluded in a
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