Integration of a Commercial Barcode-Assisted Medication Dispensing System in a Teaching Hospital

Sarah Berdot; Abdelali Boussadi; Aurélie Vilfaillot; Mathieu Depoisson; Claudine Guihaire; Pierre Durieux; Laetitia Minh Maï Le; Brigitte Sabatier

doi:10.1055/s-0039-1694749

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2019; 10(04): 615-624
DOI: 10.1055/s-0039-1694749

Research Article

Georg Thieme Verlag KG Stuttgart · New York

Integration of a Commercial Barcode-Assisted Medication Dispensing System in a Teaching Hospital

Sarah Berdot

¹Department of Pharmacy, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

²Equipe 22, Centre de Recherche des Cordeliers, UMR 1138 INSERM, Paris, France

³Department of Clinical Pharmacy, Faculty of Pharmacy, EA EA4123, Université Paris Sud, Châtenay-Malabry, France

,

Abdelali Boussadi

²Equipe 22, Centre de Recherche des Cordeliers, UMR 1138 INSERM, Paris, France

⁴Département de Santé Publique et Informatique Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

,

Aurélie Vilfaillot

⁵Unité de Recherche Clinique, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

⁶INSERM, Centre d'Investigation Clinique 1418 (CIC1418), Paris, France

,

Mathieu Depoisson

¹Department of Pharmacy, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

,

Claudine Guihaire

⁷Hospital Nursing staff (DSAP), Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

,

Pierre Durieux

²Equipe 22, Centre de Recherche des Cordeliers, UMR 1138 INSERM, Paris, France

⁴Département de Santé Publique et Informatique Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

,

Laetitia Minh Maï Le

¹Department of Pharmacy, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

⁸Lip(Sys)2, EA7357, UFR Pharmacie, U-Psud, Université Paris-Saclay, Paris, France

,

Brigitte Sabatier

¹Department of Pharmacy, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

²Equipe 22, Centre de Recherche des Cordeliers, UMR 1138 INSERM, Paris, France

› Author Affiliations

Abstract

Objectives A commercial barcode-assisted medication administration (BCMA) system was integrated to secure the medication process and particularly the dispensing stage by technicians and the administration stage with nurses. We aimed to assess the impact of this system on medication dispensing errors and barriers encountered during integration process.

Methods We conducted a controlled randomized study in a teaching hospital, during dispensing process at the pharmacy department. Four wards were randomized in the experimental group and control group, with two wards using the system during 3 days with dedicated pharmacy technicians. The system was a closed loop system without information return to the computerized physician order entry system. The two dedicated technicians had a 1-week training session. Observations were performed by one observer among the four potential observers previously trained. The main outcomes assessed were dispensing error rates and the identification of barriers encountered to expose lessons learned from this study.

Results There was no difference between the dispensing error rate of the control and experimental groups (7.9% for both, p = 0.927). We identified 10 barriers to pharmacy barcode-assisted system technology deployment. They concerned technical (problems with semantic interoperability interfaces, bad user interface, false errors generated, lack of barcodes), structural (poor integration with local information technology), work force (short staff training period, insufficient workforce), and strategic issues (system performance problems, insufficient budget).

Conclusion This study highlights the difficulties encountered in integrating a commercial system in current hospital information systems. Several issues need to be taken into consideration before the integration of a commercial barcode-assisted system in a teaching hospital. In our experience, interoperability of this system with the electronic health record is the key for the success of this process with an entire closed loop system from prescription to administration. BCMA system at the dispensing process remains essential to purchase securing medication administration process.

Keywords

electronic data processing - medication systems - medication errors - hospital information systems - integrated information systems - specific types - clinical information systems - pharmacy

Full Text

References

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Supplementary Material