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Impact of barcode medication administration on patient safety in UK hospital settings: protocol for a mixed-methods realist evaluation.

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Bibliographic Details
Title: Impact of barcode medication administration on patient safety in UK hospital settings: protocol for a mixed-methods realist evaluation.
Authors: Mahmoud A; Pharmacy, Imperial College Healthcare NHS Trust, London, UK.; Medical School, University of Exeter Faculty of Health and Life Sciences, Exeter, UK., Abdelaziz S; Pharmacy, Imperial College Healthcare NHS Trust, London, UK., McErlean M; University College London Hospitals NHS Foundation Trust, London, UK., Jani Y; University College London Hospitals NHS Foundation Trust, London, UK.; Department of Practice and Policy, UCL School of Pharmacy, London, UK., Slatter M; Royal United Hospital Bath NHS Trust, Bath, UK., Villena A; Imperial College Healthcare NHS Trust, London, UK., Bird J; Imperial College Healthcare NHS Trust, London, UK.; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK., Grailey K; Surgery and Cancer, Imperial College London Faculty of Medicine, London, UK., Taylor A; Patient and Public Involvement Partner, London, UK., Franklin BD; Pharmacy, Imperial College Healthcare NHS Trust, London, UK bryony.franklin@nhs.net.; Department of Practice and Policy, UCL School of Pharmacy, London, UK.
Source: BMJ open [BMJ Open] 2025 Nov 12; Vol. 15 (11), pp. e109619. Date of Electronic Publication: 2025 Nov 12.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms: Patient Safety* , Medication Errors*/prevention & control , Medication Systems, Hospital* , Electronic Data Processing*, Humans ; United Kingdom ; Research Design ; State Medicine ; Electronic Health Records
Abstract: Competing Interests: Competing interests: None declared.
Introduction: Barcode medication administration (BCMA) systems are increasingly being implemented in hospital settings, with the aim of decreasing medication administration errors. However, the majority of the literature demonstrating the value of BCMA in supporting patient safety is from the USA. Furthermore, little is known about the underlying mechanisms that support its use. This study aims to explore the impact of BCMA on patient safety including medication admisntration errors and nursing time spent providing direct patient care, in terms of what works, for whom, under what circumstances, and how.
Methods and Analysis: We will use a mixed-methods realist evaluation. The study will be conducted in four phases, at two London NHS teaching trusts and one South West Region NHS Trust using different electronic health record systems. Phase 1 will involve documentary analysis and a narrative review to develop an initial programme theory for how BCMA is expected to work. Phase 2 will use interviews with key informants to refine this programme theory. The programme theory will then be tested in phase 3 using mixed methods: (1) observation of nurses' medication administration; (2) analysis of alert data from the BCMA systems to understand the alerts' clinical significance and utility and (3) interviews with nurses and hospital inpatients to explore their views. These data will be triangulated to refine and finalise the programme theory in phase 4, together with recommendations for practice.
Ethics and Dissemination: The Study Coordination Centre has obtained approval (24/SC/0326) from the Oxford B NHS Research Ethics Committee and the Health Research Authority. The study's findings will be presented at scientific meetings and published in peer-reviewed journals. Additionally, summaries of the findings will be produced, targeted at relevant groups such as healthcare professionals, policy-makers and study participants.
(© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)
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Contributed Indexing: Keywords: Delivery of Health Care, Integrated; Digital Technology; Health & safety; Health policy; Safety
Entry Date(s): Date Created: 20251112 Date Completed: 20251113 Latest Revision: 20251115
Update Code: 20251115
PubMed Central ID: PMC12612751
DOI: 10.1136/bmjopen-2025-109619
PMID: 41224307
Database: MEDLINE
Description
Abstract:Competing Interests: Competing interests: None declared.<br />Introduction: Barcode medication administration (BCMA) systems are increasingly being implemented in hospital settings, with the aim of decreasing medication administration errors. However, the majority of the literature demonstrating the value of BCMA in supporting patient safety is from the USA. Furthermore, little is known about the underlying mechanisms that support its use. This study aims to explore the impact of BCMA on patient safety including medication admisntration errors and nursing time spent providing direct patient care, in terms of what works, for whom, under what circumstances, and how.<br />Methods and Analysis: We will use a mixed-methods realist evaluation. The study will be conducted in four phases, at two London NHS teaching trusts and one South West Region NHS Trust using different electronic health record systems. Phase 1 will involve documentary analysis and a narrative review to develop an initial programme theory for how BCMA is expected to work. Phase 2 will use interviews with key informants to refine this programme theory. The programme theory will then be tested in phase 3 using mixed methods: (1) observation of nurses' medication administration; (2) analysis of alert data from the BCMA systems to understand the alerts' clinical significance and utility and (3) interviews with nurses and hospital inpatients to explore their views. These data will be triangulated to refine and finalise the programme theory in phase 4, together with recommendations for practice.<br />Ethics and Dissemination: The Study Coordination Centre has obtained approval (24/SC/0326) from the Oxford B NHS Research Ethics Committee and the Health Research Authority. The study's findings will be presented at scientific meetings and published in peer-reviewed journals. Additionally, summaries of the findings will be produced, targeted at relevant groups such as healthcare professionals, policy-makers and study participants.<br /> (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)
ISSN:2044-6055
DOI:10.1136/bmjopen-2025-109619