Effectiveness of a Barcode Medication Administration System in Reducing Preventable Adverse Drug Events in a Neonatal Intensive Care Unit: A Prospective Cohort Study

Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit. We conducted a prosp...

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Bibliographic Details
Published in:The Journal of pediatrics Vol. 154; no. 3; pp. 363 - 368.e1
Main Authors: Morriss, Frank H., Abramowitz, Paul W., Nelson, Steven P., Milavetz, Gary, Michael, Stacy L., Gordon, Sara N., Pendergast, Jane F., Cook, E. Francis
Format: Journal Article
Language:English
Published: Maryland Heights, MO Elsevier Inc 01.03.2009
Elsevier
Subjects:
Automatic Data Processing - methods
Automatic Data Processing - organization & administration
Biological and medical sciences
Drug-Related Side Effects and Adverse Reactions - etiology
Drug-Related Side Effects and Adverse Reactions - prevention & control
General aspects
Humans
Infant, Newborn
Intensive Care Units, Neonatal - organization & administration
Medical sciences
Medication Errors - adverse effects
Medication Errors - prevention & control
Medication Systems, Hospital
Miscellaneous
Outcome Assessment (Health Care)
Pediatrics
Prevention and actions
Program Evaluation
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Management - methods
Risk Management - organization & administration
SD
ADE
GEE
UIHC
NICU
BCMA
CPOE
MAR
Barcode medication administration
Generalized estimating equation
Computer prescriber order entry
Medication administration record
Neonatal intensive care unit
University of Iowa Hospitals and Clinics
Standard deviation
Adverse drug event
Drug
Pediatrics
Intensive care
Toxicity
Neonatology
Pharmacovigilance
System
Intensive care unit
Prevention
Chemotherapy
Treatment
Efficiency
Follow up study
Cohort study
Secondary effect
Public health
ISSN:0022-3476, 1097-6833, 1097-6833
Online Access:Get full text
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Summary:Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit. We conducted a prospective, observational, cohort study of a BCMA system intervention in a neonatal intensive care unit. Participants were admitted neonates during 50 weeks. Medication errors and potential or preventable ADEs were detected by a daily structured audit of each subject's medical record, with assignment of an event as a preventable ADE made by blinded assessors. The generalized estimating equation method was used in modeling the targeted, preventable ADE rate with covariates. A total of 92 398 medication doses were administered to 958 subjects. The generalized estimating equation method yielded a relative risk of preventable ADE when the system was implemented of 0.53 (95% confidence limits 0.29 to 0.91, P = .04), adjusted for log10doses of medication/subject/day, a significant predictive covariate (P < .001), as well as for birth weight, sex, Caucasian race, birth cohort number, and nursing hours/subject/day. The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day, an important risk exposure.
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ISSN:0022-3476
1097-6833
1097-6833
DOI:10.1016/j.jpeds.2008.08.025