Community Hospital will soon be the first in Pasco County to use them to reduce human error in giving medications.
By MELIA BOWIE
Published October 25, 2004
NEW PORT RICHEY - Starting this week, patients who receive pills, intravenous fluids and other medication at Community Hospital will do so with a new safety net.
In an effort to reduce human error, Community soon will become the only hospital in Pasco County and one of the first in the Tampa Bay region to begin matching patients and their medicine using bar codes.
The idea is to create a higher comfort level for everyone. Hospital staff members hope the system will prevent problems with drugs that look alike or have similar names, among other worries.
"No health care provider wants to make an error ... it truly is an accident," said Genny Ginsberg, nurse education services coordinator with Community. "But sometimes bad things happen to good people," she said.
Bar coding can help.The endeavor will cost Community about $400,000 in new equipment, said administrators.
Bar coding will also help the hospital reduce its reliance on paper, they said.
Community, a 400-bed hospital owned by Hospital Corporation of America (HCA), is the first large facility in the company's southwest Florida network to implement the system, called e-MAR.
Nashville-based HCA is spending about $1.3-million to train staff at 15 regional facilities that stretch from Fort Myers to Spring Hill.
Regional Medical Center Bayonet Point and Oak Hill Hospital in Hernando County will begin using the e-MAR system next year.
Despite hefty start-up costs, HCA "said we're committed and we're doing this," said Ernie Meier, chief executive officer of Community, which is helping to pilot the program in Florida.
The goal is to use technology to eliminate medication slip-ups. The e-MAR (electronic medication administration record) system is designed to reduce such problems as improper labeling of drugs, missed or double doses of medicines, and illegible handwriting on prescriptions.
How it works
Community will begin using e-MAR on Tuesday, starting with about 19 oncology patients on its third floor, said nurse director Vicky Murphy. A paper trail will be kept during the system's trial runs.
Under the system, patients admitted to the hospital receive a special bar coded armband embedded with their medical history.
The tamper-proof strips include everything from a person's height and weight to allergies and side effects. When it is time for them to receive a drug, a nurse or therapist uses a hand-held device to scan the band every time a dose is given.
The patient's medical history then pops up on a portable laptop computer called a COW (or computer on wheels).
But people are not the only part of the electronic process.
Before any medication reaches a patient's lips, each dose is individually wrapped and bar-coded in the hospital pharmacy.
The practice provides dual coverage.
The result: If all factors fail to match up when a patient's armband is scanned, several on-screen warnings appear - alerting staff to double check, verify or call the doctor before giving the medication.
"This is a communication tool we didn't really use, didn't really have before," said Roy Coutts, a nurse and e-MAR coordinator at Community.
He estimated it will take about 10 weeks to get the system installed hospitalwide.
The hospital's outpatient clinics will begin using it within six to eight months.
New technology
In the late 1990s, the Institute of Medicine in Washington, D.C., issued a report that found 44,000 to 98,000 people nationally died of medical errors - including frequent medication mistakes.
The report, titled "To Err is Human," brought a lot of attention to the topic, said Christine Stencel, a spokeswoman for the nonprofit institute.
In recent years, several state and national health organizations have begun to maintain lists of voluntarily reported errors. However, establishing a comprehensive database remains a challenge.
The issue of medication errors and bar coding was prevalent enough to be considered for the 2005 list of national safety goals that is compiled annually by the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO, said commission spokesman Mark Forstneger.
However, the "decision was we need to look at this more carefully before we settle on bar-coding" as a practice, he said, noting "there's a lot of new and emerging technology still coming out."
Community Hospital officials say their e-MAR initiative may be cutting-edge now but could become common practice.
Eventually, "any hospital that's worth its salt will be doing something likewise," Ginsberg said.
To date, however, few facilities use the system, said Kathryn Nagel of the Institute for Safe Medication Practices in Huntingdon Valley in Pennsylvania.
In all, "3 percent or less of all hospitals have it. It's up and coming," she said.
Facilities are slow to jump on the bandwagon for a reason. Such systems are still pretty pricey, said Nagel, who also noted they have not shown a significant decrease in errors yet. Moreover, in addition to an initial e-MAR cost outlay, there is the expense of packaging medications.
In New Port Richey, Community Hospital staff will begin packaging and bar-coding individual pills - complete with expiration dates - to use with e-MAR.
Nationally, many pills still await detailed coding despite FDA rules requiring them by 2006.
Despite that timeline, officials at Community say their early start with e-MAR is more than an extra security blanket. It is also a learning opportunity.
The hospital delivers about 115,000 doses of medication each month and until now had no comprehensive way to account for how well it was doing.
Starting this week, "we'll be able to see how many near misses and which drugs are giving us the most trouble," said Coutts, the e-MAR coordinator.
"We want to see the problems" as well as the perks, he said.
Melia Bowie covers business in Pasco County. She can be reached in west Pasco at 869-6229, or toll-free at 1-800-333-7505, ext. 6229. Her e-mail address is bowie@sptimes.com[Last modified October 25, 2004, 02:35:37]
