How does the safety of medication administration compare when using barcode scanning versus manual methods?

Bottom line:  Properply used barcode medication administration technology reduces the rate of medication errors in acute care settings.

SummarySan TH, et al.  Factors affecting registered nurses’ use of medication administration technology in acute care settings: A systematic review.  JBI Library of Systematic Reviews. 10(8):471-512,  2012.
Although this systematic review addresses nurses’ attitudes and barries to using technology like barcode scanning, the Background section (p. 474), documents evidence on effectiveness of using barcodes in reducing medication errors.

Cited studies
Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, et al. Effect of bar-code technology on the safety of medication administration. New Engl J Med. 2010;362(18):1698-707.
Before and after study at academic medical center implementing barcode system. RESULTS: Investigators observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate). 41% reduction in error rate after the barcode system was implemented.

Morriss FH, Abramowitz PW, Nelson SP, Milavetz G, Michael SL, Gordon SN, et al. Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study. Journal Ped. 2009;154(3):363 – 8.
Observational study conducted during the process of installing a barcode medication administration system in a neonatal ICU. RESULTS: 92 398 medication doses were administered to 958 subjects. Relative risk of medication errors when using the barcode system was 0.53 compared to not using the barcode system.

Other studies

See this PubMed search for a focus on quasi-experimental studies:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes) AND (comparative OR before and after OR quasi-experimental)

To view a broader set of references on this topic:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes)

Continuous renal replacement therapy

Roeder, Vickey R. “Putting the ‘C’ back into continuous renal replacement therapy.” Nephrology nursing journal 40.6 (2013): 509-516.

Palevsky, Paul M, et al. “KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury.” American journal of kidney diseases 61.5 (2013):649-672.

Galvagno Jr., Samuel M, et al. “Practical considerations for the dosing and adjustment of continuous renal replacement therapy in the intensive care unit.” Journal of critical care 28.6 (2013):1019-1026.

Uchino, V, et al. “Validity of low-intensity continuous renal replacement therapy*.” Critical care medicine 41.11 (2013):2584-2591.

Rahman, Muhammad Aziz. Renal dialysis: modalities. Evidence summaries. 2013. In: Joanna Briggs Institute EBP Database.

Diagnosis and management of adults with chronic kidney disease. Southfield (MI): Michigan Quality Improvement Consortium; 2013 May. 1 p.

Honore, Patrick, et al. “Nutritional and metabolic alterations during continuous renal replacement therapy.” Blood purification 35.4 (2013):279-284.

Maursetter, Laura, C E Kight, J Mennig, and R M Hofmann. “Review of the mechanism and nutrition recommendations for patients undergoing continuous renal replacement therapy.” Nutrition in clinical practice 26.4 (2011):382-390.

Continuous renal replacement therapy (CRRT).” The Internet journal of anesthesiology 21.1 (2009).

Databases: PubMed, CINAHL, Joanna Briggs, Guideline.gov

Reviewed and updated 4/9/2014 ldt

Nursing protocols on managing neurogenic bladder and bowel.

Coggrave, Maureen, C Norton, and J D Cody. “Management of faecal incontinence and constipation in adults with central neurological diseases.” Cochrane Database of Systematic Reviews 1 (2014):CD002115.

Jamison, Jim, S Maguire, and J McCann. Catheter policies for management of long term voiding problems in adults with neurogenic bladder disorders. Cochrane Database of Systematic Reviews 11 (2013):CD004375.

Bowman, Rebecca. Bowel irrigation: clinician information. Evidence summaries. 2017. In: Joanna Briggs Institute (JBI) EBP Database.

Jayasekara, Rasika. Neurogenic bladder disorder (adult): catheter policies. Evidence summaries. 2016. In: JBI.

de Kort, L M O, et al. “The management of adolescents with neurogenic urinary tract and bowel dysfunction.” Neurourology and urodynamics 31.7 (2012):1170-1174.

Adams, Jillian, et al. “Strategies to promote intermittent self-catheterization in adults with neurogenic bladders: a comprehensive systematic review.” Systematic reviews. JBI Libr Syst Rev. 2011;9(34):1392-1446.

National Clinical Guideline Centre. “Urinary incontinence in neurological disease. Management of lower urinary tract dysfunction in neurological disease.” London, UK: National Institute for Health and Clinical Excellence (NICE); 2012. 40 p.

Databases: PubMed, Joanna Briggs, Guideline.gov Keywords: neurogenic bowel, neurogenic bladder, nurse/nursing

Reviewed and updated 4/9/2014 ldt

Updated links 10/16/2017 ldt

Patient and family stroke education

Cheng, Ho Y, Sek YChair, and Janita PChau. “The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors: A systematic review and meta-analysis.” Patient education and counseling 95.1 (2014):30-44.

Cameron, Vanessa. “Best practices for stroke patient and family education in the acute care setting: a literature review.” Medsurg nursing 22.1 (2013):51-5, 64.

Shyu, Yea-Ing L, et al. “A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers.” Journal of clinical nursing 17.18 (2008):2497-2508.

Cameron, Jill I, and Monique A MGignac. “‘Timing It Right’: a conceptual framework for addressing the support needs of family caregivers to stroke survivors from the hospital to the home.” Patient education and counseling 70.3 (2008):305-314.

O’Farrell, B, and D Evans. The continuum of care: the process and development of a nursing model for stroke education. Axone 20.1 (1998):16-18.

Olson, DaiWai, et al. Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention. Evidence report/technology assessment 202 (2011):1-197.

Hafsteinsdottir, T B, et al. “Educational needs of patients with a stroke and their caregivers: a systematic review of the literature.” Patient education and counseling 85.1 (2011):14-25.

Reviewed and updated 4/21/2014 ldt

What are the best practices for peritoneal dialysis general care and exit site care?

Rahman M.  Peritonitis in Peritoneal Dialysis: Catheter-Related Interventions and Transfer Set Modifications.  [Evidence Summaries], AN: JBI741, Last updated: 21 Jan 2014.

Rahman M.  Peritoneal Dialysis: Clinician information.  [Evidence Summaries], AN: JBI104, Last updated:  21 Jan 2014.

Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care.  Best Practice: evidence-based information sheets for health professionals. 8(1):1-7, 2004.  [Best Practice Information Sheets].  Last updated:  29 Apr 2011.

Reviewed by John Nemeth 4/14

What are the best practices on measuring blood pressure (BP)?

A search of Joanna Briggs Institute identified the following articles:

Measurement Accuracy of Non-invasively Obtained Central Blood Pressure: A Systematic Review and Meta-analysis. Cheng H, Lang D, Pearson A, Worthley S. The JBI Library of Systematic Reviews. 9(52):2166-2214, 2011.

Vital Signs. [Recommended Practices], AN: JBI2005, Updated: 02 Dec 2013.

Reviewed by John Nemeth 4/14