Effect of bar-code-assisted medication administration on medication error rates in an adult medical intensive care unit

Purpose. The effect of bar-code-assisted medication administration (BCMA) on the rate of medication errors in adult patients in a medical intensive care unit (ICU) was studied. Methods. Medication errors were identified in a community teaching hospital medical ICU using a direct observation technique whereby nurses were observed administering medications. Observations occurred for four consecutive 24-hour periods one month before and four months after the implementation of BCMA. Errors in the following categories were recorded: wrong drug, wrong administration time, wrong route, wrong dose, omission, administration of a drug with no order, and documentation error. Two evaluators reviewed all errors for accuracy. Medication error rates were calculated and compared by determining the number of medication errors identified per number of medications administered (observed) preimplementation and postimplementation of BCMA. Statistical analyses were conducted to determine significance. Results. A total of 1465 medication administrations were observed (775 preimplementation and 690 postimplementation) for 92 patients (45 preimplementation and 47 postimplementafion). The medication error rate was reduced by 56% after the implementation of BCMA (19.7% versus 8.7%, p < 0.001). This benefit was related to a reduction associated with errors of wrong administration time. Wrong administration time errors decreased from 18.8% during preimplementation to 7.5% postimplementation (p < 0.001). There were no significant differences in other error types. Conclusion. The implementation of BCMA significantly reduced the number of wrong administration time errors in an adult medical ICU.