Discussion 8-1

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Southern New Hampshire University *

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Mechanical Engineering

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Feb 20, 2024

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Initial Post: Reflect on what you have learned in this course. What is one change you will make to your current practice based upon your knowledge gained in this course? What were the challenges and benefits of your project? Please provide a scholarly source to support your ideas. While we have covered a wide variety of topics within this course, the knowledge that I gained the most of was information surrounding barcode scanning. I decided to do my project on barcode scanning because up until a year ago I worked at facilities that were either still utilizing paper charting or had advanced to entry level computer charting that didn’t support the use of barcode scanning. For me, it was a change I was afraid of because I had gotten so used to my individual practice, especially when it came to keeping myself and my patients safe when doing medication administration. I had become so accustomed to my own checks and balances during medication administration that I was concerned I would have errors because I was changing my process. Fortunately, I did not experience any issues or concerns when transitioning to an organization that utilized barcode scanning, but it made me wonder more about the technology and how it’s being implemented in the nursing profession. When researching the topic of barcode scanning, I did not find many challenges. I found the literature to be vast and largely supportive of the technology. There are several benefits of barcode scanning and researching this topic touched on some of my personal practice, allowing for me to reflect on my own actions especially surrounding the medication administration process. Jessurun et al., (2021) found that barcode scanning technology was beneficial in decreasing safety events and medication errors while Gauthier-Wetzel (2022) discussed that barcode scanning improves safety by reaffirming a patient’s identity prior to administering medications or performing a procedure. Barcode scanning had significant
positive effects on safe outcomes of patients while improving quality of care. With the use of barcode scanning technology medication errors dropped 44% adverse events were decreased by nearly 60% (Thompson et al., 2018). This project provided a significant personal benefit for me. There had been times during the past year where the barcode scanner would malfunction or a barcode was unreadable, which led me to make the decision to override the scanner so that I could administer the medication in a timely matter. I reverted to my old practice of confirming a patients 5 rights and then verifying a patient using two identifiers before administering the medication. It turns out, I wasn’t the only one who utilized this practice when running into technology troubles. There is literature to support some disadvantages regarding barcode technology. In one study, nearly half of the staff working failed to scan medications due to reports of scanner malfunction or equipment that was faulty, broken or missing (Naidu & Alicia, 2019). Unfortunately, this can not only place patients at risk, but there are several legal consequences that can arise from overriding the scanners (Bowdle et al., 2023). Legal implications can be far-reaching and leave a wave a devastation for those involved. Failing to follow hospital policy by instituting workarounds to the technology can lead to claims of negligence with lawsuits possible for the facility and the staff involved (Van Der Ween et al., 2018). It is because of this information that I have made it a point to ensure I never override the equipment. It only takes a few minutes to go find another computer and scanner. Doing so will provide safety and peace of mind for me knowing I am within the bounds of policy and taking necessary steps to keep patients safe and myself away from any troubles. Without a doubt, utilizing barcode scanning 100% of the time is a change I will be implementing into my practice.
References Bowdle, T. A., Jelacic, S., Webster, C. S., & Merry, A. F. (2023). Take action now to prevent medication errors: Lessons from a fatal error involving an automated dispensing cabinet. British Journal of Anaesthesia , 130 (1), 14–16. https://doi.org/10.1016/j.bja.2022.09.017 Gauthier-Wetzel, H. E. (2022). Barcode Medication Administration software technology use in the emergency department and medication error rates. CIN: Computers, Informatics, Nursing , 40 (6), 382–388. https://doi.org/10.1097/cin.0000000000000846 Jessurun, J. G., Hunfeld, N. G., Van Rosmalen, J., Van Dijk, M., & Van Den Bemt, P. M. (2021). Effect of automated unit dose dispensing with barcode scanning on medication administration errors: An uncontrolled before-and-after study. International Journal for Quality in Health Care , 33 (4). https://doi.org/10.1093/intqhc/mzab142 Naidu, M., & Alicia, Y. L. (2019). Impact of bar-code medication administration and electronic medication administration record system in clinical practice for an effective medication administration process. Health, 11(05), 511– 526.   https://doi.org/10.4236/health.2019.115044 Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens, J. M. (2018). Implementation of bar-code medication administration to reduce patient harm.  Mayo Clinic Proceedings: Innovations, Quality & Outcomes 2 (4), 342–351. https://doi.org/10.1016/j.mayocpiqo.2018.09.001 
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Van Der Veen, W., Van Den Bemt, P. M. L. A., Wouters, H., Bates, D. W., Twisk, J. W. R., de Gier, J. J., Taxis, K., Duyvendak, M., Luttikhuis, K. O., Ros, J. J. W., Vasbinder, E. C., Atrafi, M., Brasse, B., & Mangelaars, I. (2018). Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals.   Journal of the American Medical Informatics Association: JAMIA ,   25 (4), 385– 392. https://doi.org/10.1093/jamia/ocx077 Peer Post (x2) In responding to your peers, please discuss how advancements in health information technology are making our healthcare system a system focused on safety. Identify one future trend in HIT. Peer Post 1: Gina, I enjoyed the information you shared on the divide between those who had a level of health literacy and those who did not. Unfortunately, the pandemic seems to have really highlighted that contrast. Did you notice any research that made any connections to the level of health literacy and the amount of misinformation that was both circling and believed in? I can agree with your sentiments on the project as well. I chose barcode scanning for the project and I found that it took an overbearing and rather extensive amount of time to research and then build out the project. While I am happy with the outcome of my project, I agree that it was an exhausting process to overcome and work through. I hope you do well! Advancements in health information technology (HIT) are having significant positive impacts to the healthcare system, leading to a safer environment for patients. One of those
improvements is barcode scanning. Jessurun et al., (2021) demonstrated that harmful errors from medication administration fell to a mere 0.3% and that when the scanning technology was implemented into an emergency department their medication errors fell by 11%. Automation of processes decreases adverse incidents leading to safer patient outcomes. Automating the verification process of the 5 patient rights prevents medication and procedure errors on patients (Mulac et al., 2021). In the past few years, wearable technology has increased tremendously and is seen as a future trend in HIT. These devices worn on a patient’s body help with tracking things such as vital signs and physical activity while also providing real time feedback on their health and progress ( Tavakoli et al., 2020). Progress continues to be made in advancing this technology into other monitoring capabilities within healthcare. Brain waves and bio feedback from muscles are also being advanced through wearable technology (Tavakoli et al., 2020). As wearable technologies continue to be advanced, more real time information can be obtained. This certainly can point to wearable technology being a data driven advancement when considering the future of HIT. References Jessurun, J. G., Hunfeld, N. G., Van Rosmalen, J., Van Dijk, M., & Van Den Bemt, P. M. (2021). Effect of automated unit dose dispensing with barcode scanning on medication administration errors: An uncontrolled before-and-after study. International Journal for Quality in Health Care , 33 (4). https://doi.org/10.1093/intqhc/mzab142
Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations.   BMJ quality & safety ,   30 (12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223 Tavakoli, M., Carriere, J., & Torabi, A. (2020). Robotics, Smart Wearable Technologies, and autonomous intelligent systems for Healthcare during the COVID‐19 pandemic: An analysis of the state of the art and future vision. Advanced Intelligent Systems , 2 (7), 2000071. https://doi.org/10.1002/aisy.202000071 Peer Post 2 Hi Trudy, I enjoyed reading this post, especially when you reflected on working in a healthcare setting that still does not utilize HIT. I transitioned from one facility to another, going from paper charting to HIT technologies everywhere and I must admit that it felt like an uphill battle at first. I am also excited to see that you have some utilization of telehealth. I can see where not being surrounded by and immersed in HIT would make it difficult to do the project, though I like the angle you took of investigating ways to implement HIT in your facility and practice. In completing the final research for this class, I found research that speaks on an up-and- coming trend in HIT that utilizes virtual reality to bring patients closer to doctors, especially in specialty areas that may otherwise be unreachable due to physical proximity to the patient. Examples of this technology include bringing several doctors together in the same room through
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automated reality screens to provide their expertise safely and physically on the patient (Tavakoli et al., 2020). These systems are also being developed to operated robotic systems from other locations. Virtual headsets are being used to move robots and perform diagnostic tests with the operator being in another location from the robot altogether (Tavakoli et al., 2020). This technology is being investigated and developed to work in hard-to-reach areas or areas recently devastated by a disaster. Tavakoli et al., (2020) found that the use of virtual controlled robots may be the most practical way to care for patients in these environments. References Tavakoli, M., Carriere, J., & Torabi, A. (2020). Robotics, Smart Wearable Technologies, and autonomous intelligent systems for Healthcare during the COVID‐19 pandemic: An analysis of the state of the art and future vision. Advanced Intelligent Systems , 2 (7), 2000071. https://doi.org/10.1002/aisy.202000071