Monday, July 07, 2008
Bar codes not a cure-all
…When you go into the hospital, you get a wristband and are identified with a bar code just like a can of tuna.
…The idea is to match you to bar codes on medicines you take or that are given in your IV or with blood products. This was designed to reduce medication errors.
…Some scientists the Universities of Pennsylvania and Wisconsin have now studied this, according to Josh Goldstein, writing in the Philadelphia Inquirer (July 1, 2008).
…They spent years looking at the system in five hospitals and found that not only did this not cut errors, but efforts to sidestep the system might have caused other problems.
….There has to be a safety mindset, they concluded, not just a computer rolled up near the bed.
…In 2006, 400,000 medication errors occurred, and 9,000 people died.
…About a third of the nation’s hospitals have this technology and the rest are working to get it.
…But, say insulin is in a fridge on a different floor. A busy nurse may copy the bar codes on her floor so she can get the insulin—far from the bedside.
…Or if a patient is contagious or the room full of equipment, the computer may be left in the hall and the nurse not hear if it beeps an objection to what is being given. Or the computer batteries can die.
…About 4.2% of the time, the nurse overrode the scanner because the wristband was damaged.
…The scientists urged the hospital administrators to see how these systems really worked—you know, stand at bedsides and watch.
...Yes, leave your office, check in with the real world.