News | July 24, 2007

Bar Codes Help Reduce Drug Snafus

July 25, 2007 — Patients admitted to Milton Hospital and New England Sinai Hospital and Rehabilitation Center should take a closer look at the bracelet wrapped around their wrist.

No longer just pieces of plastic with a barely legible name on them, bracelets at the two hospitals now have an electronic bar code that could prevent a life-threatening drug reaction. The two facilities are the first private hospitals on the South Shore to use a bar code and scanning system to prevent common medication errors and patient mix-ups.

‘‘It’s just like the supermarket, but you’re scanning something that is much, much more important than a can of peas,’’ said Karen Hughes, vice president of nursing at New England Sinai.

In May, New England Sinai in Stoughton and Milton Hospital began using the systems, which are similar to the equipment at a grocery store checkout. Brigham and Women’s Hospital in Boston and area veterans hospitals have also introduced the bar code systems at patients’ bedsides.

‘‘Only about 10 percent of the hospitals in the U.S. have made the leap to bar code medication verification,’’ Hughes said. ‘‘We’re really in the forefront.’’ Lynn Cronan, director of professional development and informatics at Milton Hospital, said bedside medication verification is expected to eliminate errors from the more than 500,000 drugs dispensed a year from its pharmacy.

‘‘It’s another tool,’’ Cronan said. ‘‘It doesn’t replace judgment on the part of nurses, but it will prevent giving the wrong pill at the wrong time to the wrong patient.’’

How it works is simple: When a patient is admitted, that person’s medical history, age, weight, height, diagnosis and drugs the patient will be given are entered into a computer. At bedside, a nurse scans a bar code on the bracelet and a bar code on the drug. A computer determines if the drug and dose are correct. If not, an alarm sounds. Addressing medication errors, as well as wrong surgeries, became a higher priority after a 1999 report by the Institute of Medicine that concluded more than 7,000 people die annually from medication errors.
A similar report in 2006 found medication errors harmed more than 1.5 million people a year and cost hospitals at least $3.5 billion extra to correct those mistakes.

The state Department of Public Health does not require hospitals to report medication errors unless they cause severe harm, said spokeswoman Donna Rheaume. In most cases, Milton’s Cronan said, an error is caught before it gets to the patient.

‘‘What we commonly see are near misses,’’ she said. Missing a dosage, overdosing, giving a drug at the incorrect time or administering the wrong one can cause a headache, a seizure or death.

Four years ago, the Food and Drug Administration required drug makers to place bar codes on bottles and packages, a first step toward mechanizing drug administration in hospitals. The 172 veterans hospitals across the country have installed the necessary equipment for bar code scanning, but 90 percent of private medical centers and hospitals lag behind. Area administrators say that partly has to do with cost and partly to do with paperwork.

Milton Hospital has spent the last two years updating its computer systems just to allow the implementation of the bar code system. Thousands of paper forms, applications, patient histories, nurses’ notes, doctors’ notes and handwritten prescriptions that pass through the hands of more than 60 people per patient had to be entered into computers. The hardware and software for the bar code scanning system, not including training time, cost more than $100,000, said Alexis Gordon, a Milton Hospital spokeswoman. South Shore Hospital in Weymouth and Jordan Hospital in Plymouth are revamping their systems to streamline services and safeguard patients, although neither has implemented a bar code.

‘‘We’re not there yet,’’ said John Looney, spokesman for Jordan Hospital. ‘‘We’re looking forward to it, but it won’t be until next year.’’