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Barcode system for drugs is not fool-proof
The Institute for Safe Medication Practices warns that just because the barcode system has issued an audible beep it does not necessarily mean the nurse has delivered the correct medication or dose to the correct patient at the correct time.

Barcode systems beep when scanned, and that is all the beep signifies, the institute says. It is up to the nurse to check for any error messages on the eMAR or hand-held screen. “Unfortunately, some nurses have mistakenly relied on the sound of the beep alone to signal verification of the patient and medication, particularly if the eMAR is not visible during the actual scanning process,” the institute notes in a recent alert.

The eMAR is often displayed on a mobile cart or workstation on wheels that is employed with bedside scanning systems to enhance access during medication selection and administration. “Various circumstances may result in not bringing the mobile cart into the patient's room or to the bedside so the eMAR is visible to the nurse during the scanning process. The cart may not fit in the room or at the bedside due to medical equipment or visitors, or an obstacle, such as a slight rise or bump at the doorway, may make it difficult to move the cart into the room,” the institute says.

Worse yet, “a nurse may mistakenly believe that it is not always necessary to bring the cart/eMAR to the patient's bedside, particularly if the nurse has become accustomed to the at-risk behavior of not bringing a paper MAR or eMAR to the bedside before implementation of the barcode scanning technology,” it adds.

“Whether you are in the planning stages for bedside barcode scanning technology or a seasoned user, hospitals need to identify conditions that may result in absent or poor visibility of the full eMAR during the entire medication administration process, including during the scanning process, so these problems can be resolved. This includes situational conditions, such as periods of time when the patient has several visitors at the bedside, so plans can be made regarding how to address these issues. It's also important to educate users up front about the difference between the audible beep with a registered scan and actual verification of the correct patient and medication when using bar-coding technology,” the institute says.