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Doubts cast on patient barcodes as research finds plethora of problems

  • 2 Comments
Barcode technology brought into hospitals to reduce clinical errors can be so problematic that nurses have to come up with ways of working round it, US researchers have warned.

The NHS is introducing the technology, which allows patients to be matched to their care via patient identification codes on wristbands, medications and equipment.

The government said the ‘case for coding is compelling’ and there was evidence of improved patient safety.

However, a study published in the Journal of the American Medical Informatics Association has identified a catalogue of problems with the technology that has prompted nurses to try and find ways of working round it.

Researchers looked at how the technology was being used at five hospitals, assessing around 500,000 examples of nurses and other staff scanning wristbands and medications.

Examples of problems included medication barcodes that were unreadable due to tearing or smudging, non-barcoded medications, malfunctioning scanners, missing or unreadable patient wristbands – sometimes because they had been chewed – and lost wireless connectivity.

In some cases, if a pharmacy sent two 10mg tablets for a 20mg order, the system would not accept the medication. Nurses had to override the scanning system to administer drugs to patients on 14% of occasions.

Researchers found nurses were ingenious in working around the problems.

For example, they fixed extra copies of patient ID barcodes on desks, scanning machines and clipboards.

‘It’s not that staff are lazy or careless – it’s that the system does not work as well as it should,’ said the authors.

Department of Health guidance, published last year, called on the NHS in England to adopt the GS1 barcoding standards system, which 110 hospitals have signed up to so far. The total is expected to reach 175 by the end of
this year.

Neil Lawrence, business area project manager for NHS Connecting for Health, insisted the introduction of barcode technology had been thoroughly assessed for patient safety and was progressing well.

‘The use of automatic identification and data capture (barcodes) has been picked up very quickly as everyone from manufacturers to nurses has realised the benefits,’ he said.

  • 2 Comments

Readers' comments (2)

  • RE: Doubts cast on patient barcodes as research finds plethora of problems

    Patient identification through the use of coding technologies is having an extremely positive effect on both patient safety and the use of nurses’ time.

    Your article gives the impression that the US research was damning in fact the research says that, despite the difficulties, the technology offers many benefits.

    The important question to consider is not whether it is perfect but whether it is better than what went before.

    The answer of course is; far better. In the UK approximately 10% of inpatient episodes result in errors of some kind, about half are preventable. Each year 850,000 patient safety incidents cost NHS about £2 billion in extra hospital days.

    Coding helps to reduce these figures. Coding also helps nurses carry out some of their tasks more quickly and efficiently enabling them to spend more time on patient care and less on administrative work.

    If hospitals procure the right equipment, hardware, bar code labels and software it will avoid malfunction such as tearing or smudging of medication bar codes.

    We would also emphasise the importance of educating staff on the coding system, both by raising awareness of the future benefits and by providing comprehensive training on the day to day use of the technology.

    Roger Lamb
    Healthcare Manager, GS1 UK



    Unsuitable or offensive? Report this comment

  • RE: Doubts cast on patient barcodes as research finds plethora of problems

    Patient identification through the use of coding technologies is having an extremely positive effect on both patient safety and the use of nurses’ time.

    Your article gives the impression that the US research was damning in fact the research says that, despite the difficulties, the technology offers many benefits.

    The important question to consider is not whether it is perfect but whether it is better than what went before.

    The answer of course is; far better. In the UK approximately 10% of inpatient episodes result in errors of some kind, about half are preventable. Each year 850,000 patient safety incidents cost NHS about £2 billion in extra hospital days.

    Coding helps to reduce these figures. Coding also helps nurses carry out some of their tasks more quickly and efficiently enabling them to spend more time on patient care and less on administrative work.

    If hospitals procure the right equipment, hardware, bar code labels and software it will avoid malfunction such as tearing or smudging of medication bar codes.

    We would also emphasise the importance of educating staff on the coding system, both by raising awareness of the future benefits and by providing comprehensive training on the day to day use of the technology.

    Roger Lamb
    Healthcare Manager, GS1 UK



    Unsuitable or offensive? Report this comment

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