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Improved Method of Safe Medication Delivery

9/26/2008 

Giving a child his or her medication seems simple enough. Swallow this pill, drink that fluid and you’re done. Not so fast. Checks and balances need to be in place to make sure this is done properly.

For years, nurses have served as the last line of defense against medication errors. At Children’s Hospital Central California, our nurses and respiratory care practitioners (RCPs) are equipped with a new system, called Bedside Medication Verification (BMV), that reduces such errors and ensures a parent’s most precious commodity, his or her child, is safe.

Rolled out at Children’s in August 2008, BMV is a system for medication administration and documentation. It assures the 5 Rights of medication administration, a healthcare standard, are completed before a medication is given. The 5 Rights are the right patient, the right route, the right dose, the right time and the right medication.Bedside Medication Verification System

A key component of the BMV system is a device called the Motion ® C5. The next time your child stays at Children’s, the nurse or RCP you encounter will carry this sleek, white computer tablet. Similar to a laptop computer, the C5 uses the Windows platform, has a virtual keyboard, a digital pen and provides access to the Hospital’s clinical information system. Nurses and RCPs use the C5 to scan all medications and all patients prior to administering drugs. Each dose is automatically logged into the patient’s electronic medication administration record (eMAR). Whether at the bedside, the nursing station or in the pharmacy, updates and changes to the eMAR can be viewed immediately.

Children’s Hospital transitioned to BMV because it wanted to see how it could do better in this area of patient safety. While medication barcode scanning is not new to Children’s, the new BMV system reduces the potential for medication-related errors, resulting in improved safety for our patients. The previous system utilized a device designed solely for scanning the medication and the patient. The eMAR remained on the device so individuals who needed to see what a patient was taking had to look on that particular device. With the C5, not only can nurses and RCPs scan medications and patients, they can use it to access and update patient records. Plus it streamlines their workday since they no longer have to broker for time on a share desktop computer at the nursing station. Each nurse and RCP per shift has his or her own C5.

BMV also allows Children’s to ensure the safety of the entire medication management process, not just the task of administering medications. The physician writes the medication order, which is faxed to the pharmacy. The pharmacist verifies, fills and enters the order into the eMAR. The nurse or RCP receives the medication, makes sure it matches the eMAR and the physician’s written order and then administers the medication.

The kids we serve are fragile and have complex health problems. The margin of error is small because kids, unlike adults, do not have the same ability to compensate if a medication error is made. This move to BMV is supported by the Joint Commission’s National Patient Safety Goals, which calls for using medications safely. Also it supports our mission to provide outstanding healthcare.

Currently BMV is used in all inpatient units and the emergency department. In the coming years, the C5 will be used to provide additional functionality to physicians, nurses and RCPs including online clinical documentation.