Nursing Informatics in Medication Administration

      Bar Code Medication Administration (BCMA) is a point-of-care software solution that addresses the uncompromising issue of medication errors by electronically validating and documenting medications for patients. It ensures that the correct patient receives the correct medication, the correct dose, at the correct time, via the correct route, and visually alerts nursing staff when the proper parameters are not met (United States Department of Veteran Affairs, 2006a). The primary cause of error-related in patient deaths is adverse drug events such as medication errors that result in patient harm.

      Another advantage of this software is that when the user hovers the cursor over the text a hover hint will appear that contains the complete text for the order. A Clinical Danger Level is set for each order check by the local site. Where the Clinical Danger Level is set determines whether or not the order check requires the clinician to enter a justification. For example, the pharmacy package determines if a drug-drug interaction is critical or significant. Each site then determines whether the provider must enter a reason for override.This is done by setting a Clinical Danger Level in CPRS for the Critical Drug Interaction and Significant Drug Interaction order checks. If the Clinical Danger Level is set to High for an order check, the clinician must enter a justification for overriding the order check. If the order check has a lower Clinical Danger Level, CPRS does not require the clinician to enter a justification.
      Allergy assessments also use order checks. If the site has set the No Allergy Assessment order check Clinical Danger Level to High and the patient does not have an allergy assessment, the order will require a justification for override. If the site has set the Clinical Danger Level to Moderate, no reason for overriding the order is required. When a user enters a high clinical danger level override justification, the justification for override is sent with the orders to ancillary packages that are integrated into the CPRS system so that the information is available to their users. For example, a user of the clinical dietetics package would see the justification for an allergy order to be overridden.
      The printout of the order is generated on the pharmacy printer, and the pharmacist verifies the medication order as well as the result of all the order checks. Then the pharmacy Robot retrieves the correct medication and places it in the patient’s medication drawer. The pharmacy technician then places the medication drawer on the medication cart and delivers the cart to the medication room on the unit where the patient is located.
      At the time that a printout of the order is generated to the pharmacy printer, another printout is also generated to the ward printer. This happens in order to alert staff that there are new medications ordered by the physician on one of their patients. The physicians generating these orders can be anywhere in the facility where they have access to a VA computer.The RN verifies the medication order in CPRS which then places the verifying RN’s initials on that medication order on the BCMA screen. When a nurse administers medication using BCMA, the first step is to log onto a laptop which has BCMA loaded onto it.

to be continued...Medication Administration of BCMA CLICK HERE!