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PSNet: Patient Safety Network
Journal Article

Development and implementation of a subcutaneous insulin pen label bar code scanning protocol to prevent wrong-patient insulin pen errors.

MacMaster HW, Gonzalez S, Maruoka A, et al. Joint Commission journal on quality and patient safety. 2019;45:380-386.

Insulin is a widely used high-risk medication. This quality improvement intervention employed barcode medication administration and a standardized electronic health record–integrated workflow to successfully reduce wrong-patient insulin pen errors. The authors call for widespread implementation of medication safety improvements into electronic health records.