Week 5 - barcoding and patient safety Flashcards
what is GS1
GS1 is a global non-profit automatic identification and Data Capture (AIDC) standards organization that manages many international data standards
where are GS1 standards employed
employed across a number of businesses ranging from grocery and clothing retailers, agricultural equipment and HC products and processes
GTIN - what does it abbreviate
global trade mark item number
Types of barcodes
UPC A GS1 (GTIN 12)
GS1 DataBar (GTIN 14)
GS1 DataBar expanded
GS1 DataBar composite
GS1 datamatrix
GS1 QR Codes
What bar codes are strictly 1D
UPC A GS1 (GTIN 12)
GS1 DataBar (GTIN 14)
GS1 DataBar expanded
Mixed 1D and 2D databar
GS1 DataBar Composite
2D compact databar
GS1 Data Matrix
what databar is not yet approved for use in product automated ID
GS1 QR codes
what does Bar coding bring efficiency and transparency to
retailers
manufacturers
suppliers
consumers
what parts of the medication use system are enhanced by bar coding
Dispensing and administration
Why bring automation to healthcare
to reduce medical error
where do errors occur the most in the medication use system (order)
Prescribing > Administering > transcribing > Dispensing
Top 3 types of errors
1) wrong dose
2) wrong choice
3) wrong drug
What are the two types of human errors
Slips and mistakes
define slips
an action that is either forgotten or the action is performed using an incorrect product or on the wrong target
These are examples of what:
choosing the wrong medication by not reading a label carefully, choosing a wrong patient, or omitting a scheduled dose.
slips
define msitakes
an error in execution where a human is generally alert, but consciously chooses the wrong action in the incorrect manner
these are examples of what:
calculation mistake, incorrectly setting a pump rate, selecting an incorrect medication, choosing incorrect information to apply to the clinical situation.
mistakes
Goal of automation
reduce errors
at what stages does automation seek to reduce errors
at the pints of prescribing tanscribring dispensing and administration that are related to SYSTEM issues, through the use of infromation technology and automation
Role of automated support
routine medication process tasks can be best supported by carefully-planned automated support
- reduces potential for inadvertent human error
- maximizes opportunity for patient focused care
incorporating automation and bar code scanning at inventory, medication repackaging, dispensing, compounding, and drug distribution effectively: (4)
reduce reliance on memory
improves communication
improves access to information
improves productivity and team work
shared belief on automation
importance of medication automation for improving medication safety
Medication product chain
pharmaceutical manufacterer
warehouse and shipping
HC contracting and purchasing
institutional or retail inventory storage
pharmacy compounding
pharmacy dispensing
pateitn care area storage of bulk or individual therapies
drug/dose selection
dose administration to patient
pharmacy has to ensure safe efficient and effective delivery of medication therapy
- what stages: 6
Medication re-packaging / pre-packaging to unit of use / unit dose packages from the original manufacturer’s bulk product
sterile and nonsterile medication compounding
medication dispensing
medication distribution from the pharmacy to designated patient care areas
restocking of a medication storage area on the patient care unit
medication dispensing of the Rx to a consumer
Medication automation systems: (5)
automated pharmacy inventory management/ vertical carousel technology
automated packagers
Robotics
automated medication cabinet
smart infusion devices
automated pharmacy inventory management/ vertical carousel technology
(4 adv)
- better controlled and tracked,
- improving space utilization,
- inform where a product,
- reduce walking and searching
Automated packagers
repackage and label bulk supplies of medications into patient specific unit doses of medications
robotics (4 uses)
pharmacy inventory
repackaging
fast and accurate medication dispensing
returning drug stock to inventory for unused unit of use medications
Automated medication cabinet
-7 benefits
increase authorized access to both medications and patient info
improve medication security
improve medication trunaround time
increased productivity
medication accuracy and safety
improvement in patient care
improvement in drug use management and inventory
Smart infusion devices
- combined with bar coding
provide automated ID options for pump programming (including the GS1 datamatrix bar code)
-significantly enhance safety features of these devices
Smart infusion Devices
-bar code ID of user and patient
smart infusion device may reduce error potential to administer the wrong drug/ rate/patient and can also auto-ID the care provider as well as auto-ID the patient
Canadian drivers for medication bar coding -who regulates DIN
- DIN is unique to what
- what is not included in DIN
- Canada health infoway designated what as CAS
- 2 others
In canada while the DIN is regulated by HC and designated to a pharmaceutical product:
the DIN is uique to the API, str, unit of measure, dsg form, and manufacturer BUT
DIN does not reflect package sizze
Canada health infoway designated GS1 GTIN as Canadian Approved Standard (CAS) for uniquely ID’ing pharmaceuticals throughout ea stage of the medication use process
Canadian Pharmaceutical Bar Coding Project (ISMP)
Canada Vaccine Bar coding initiative (PHAC)
Canadian vaccine Bar coding initiative (PHAC)
- when work begin
- what types of bar codes (primary package and secondary package and case level package)
see slide 28 for parts of bar code
work began around 2007
80% vaccine prods as of 2018 have
- 2D bar codes on primary packaging
- 2D linear bar codes on secondary package
- GS1-128 bar code on the case level package
Why not bar code and automation everywhere (8)
infrastructure considerations
workflow process considerations
selection of bar code symbology
hardware decisions
employee ID badges/Patient ID badges
staff resistance -need health technology assessment (HTA) - evaluate: \+evidence (efficacy \+economics (cost effectiveness) \+ ethical issues (patient preference)
