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Perspectives on Safety > Perspective
with commentary by Jeffrey M. Rothschild, MD, MPH; Carol Keohane, RN, BSN, Bar Coding for Medication Safety, September 2008
Medication safety in hospitals depends on the successful execution of a complex system of scores of individual tasks that can be categorized into five stages: ordering or prescribing, preparing, dispensing, transcribing, and monitoring the patient's response. Many of these tasks lend themselves to technologic tools. Over the past 20 years, technology has played an increasingly larger role toward achieving the five rights of medication safety: getting the right dose of the right drug to the right patient using the right route and at the right time. While several of these technologies may incur significant upfront and maintenance costs, the net impact over time may be reduced overall institutional costs and improvements in work efficiency. Examples of technologic tools commonly seen in many hospitals today include computerized provider order entry (CPOE) with decision support and automatic dispensing carts, also known as medication dispensing robots. While outside the scope of this Perspective, it is important to emphasize that many nontechnologic interventions, such as clinical pharmacists on physician rounds, can be equally effective in improving medication safety.
Journal Article > Study
Pedersen CA, Schneider P, Scheckelhoff DJ. Am J Health Syst Pharm. 2009;66:926-946.
Conducted by the American Society of Health-System Pharmacists (ASHP), this survey of more than 1300 pharmacy directors sought to evaluate the use of safety measures targeting medication dispensing and administration errors. Some positive signs were found in that use of proven technologies such as bar coding and smart infusion pumps has increased, but the overall proportion of hospitals using these technologies remains relatively low. Only a small proportion of hospitals had pharmacists attached to the emergency department (ED) or reviewed medication orders in the ED for errors. Prior surveys by the ASHP have examined the use of safety mechanisms for preventing prescribing and transcribing errors.