I understand that it is not difficult to ad a prefix or suffix to the
labels and not the band or vice-versa that prevents the scanner from
reading that number for bmv.  There was a note in the L several months
ago about this.  

 

  _____  

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Horsley, Randi -
CRH
Sent: Tuesday, June 26, 2007 4:50 PM
To: 'Roy Coutts'; Sharon LaDuke; Bowles, Jodi; meditech-l@mtusers.com
Subject: Re: [MEDITECH-L] eMAR/BMV

 

I am not the one that did it at this facility, but we had our MIS/NPR
gurus alter the patient ID label so that the account and MRN numbers are
combined on the barcode of ALL labels EXCEPT the one that is designated
clearly for the ID band. Any equipment that is designated to function
using the barcode (Accuchecks, BMV scanners, etc) will not recognize the
other labels' number. That cut off some of the very creative workarounds
with labels we had seen even though the policy is scan the ID band only.


 

  _____  

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Roy Coutts
Sent: Tuesday, June 26, 2007 12:27 PM
To: Sharon LaDuke; Bowles, Jodi; meditech-l@mtusers.com
Subject: Re: [MEDITECH-L] eMAR/BMV

Hi Jodi,

 

I have seen many of the same workarounds that Sharon has mentioned.
While I was visiting a sister hospital, I noticed every room had a
poster in it that said something like "We scan the band every time".
They did some sort of marking campaign and had a great little mascot in
the shape of a pill saying they always scan the medications and ID band.
If the patient was not scanned they had the phone number to the
administration office to be reported by the patient.

 

I'm not sure how well it worked but I am sure having the patients
involved with their own care and possibly catching a nurse perform a
workaround put pressure on them to do things correctly.

 

Roy Coutts
Project Manager
Interface People, LP
396 W. Main St, Lewisville, TX, 75057
office: 214.222.1125 
fax: 214.292.9783
[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> 

 

  _____  

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sharon LaDuke
Sent: Tuesday, June 26, 2007 2:05 PM
To: Bowles, Jodi; meditech-l@mtusers.com
Subject: Re: [MEDITECH-L] eMAR/BMV

 

What I personally saw as a nursing director was

1)       scanning a label instead of the ID band on the patient's wrist.
This was in a facility that had big med carts on wheels, with a laptop
attached, and a hardwired scanner. The nurses said they were scanning
labels because "it makes too much noise to roll the med cart across the
threshold to the room, and we don't want to wake up the patient". A real
barrier to rolling the med cart into the room was that the nurse often
had to move furniture and equipment around to be able to get close
enough to the patient to reach him with the hard-wired scanner. The
label-scanning thing was happening at a lot of facilities until everyone
figured out that they had to have a way to ensure that the ID band, and
only the ID band, could be scanned in the eMAR system. So you need a way
to allow the system to differentiate between ID bands and labels. And it
might be helpful to consider what equipment is being provided, whether
nurses have room to get the equipment to the patient, etc. For training
purposes, I think you have to emphasize that scanning is a form of
documentation, and point out the illegality of intentionally falsifying
information and what the consequences could be. 

2)       opening medications prior to scanning - this is a big no no -
works OK in some circumstances, but you have to draw the line somewhere.
Otherwise, you have nurses who will open meds at the nurses station two
hours ahead of time, if that's when they have a free moment. Two hours
later - or 10 minutes later - if those meds haven't been under that
nurse's direct observation for the entire time, who is to say what's in
there now? Plus, if the nurse opens containers before scanning, the bar
code labeled can be ripped. You then have nurses looking through the
patient's med drawer for another pill so they can scan THAT one instead.
The nurse THINKS it's the same pill, but is it? As far as training goes,
this may be a more subtle point. It is more obvious to people, I think,
that scanning something other than the bracelet on the patient's wrist
is wrong. There may need to be discussion and consensus among nursing
leadership regarding the issue of opening meds before scanning, so that
everyone is on the same page. There may be times and settings when this
could be permissible and those may need to be defined.

3)       scanning the med but using the recall function at the "patient
name" prompt, instead of scanning the patient - the system was
reconfigured so that this could no longer be done. I don't know if this
was happening outside of my multi-site hospital system. You'll want to
check and make sure your system doesn't let you do that.

4)       rarely scanning for whatever reason - training, attitude,
and/or the belief that no one is paying attention (the standardized stat
reports can be used to disabuse nurses of the notion that nobody knows
what they are doing). Scanning numbers can also be down because there
simply isn't enough equipment to go around, eg 5 nurses on a unit
sharing 4 med cart/emar laptops, or because equipment is poorly
supported, eg IT tech staff insisting that all the laptop problems are
due to stupid users. What I (and others) would like to see happen is a
follow-up retraining about one month after initial eMAR/BMV training

5)       using the edit function (if I recall correctly) to "backtime"
medication administration time, to make it look like the med was given
within the (admittedly unrealistic) 30 minute administration window.
This, too, could be tracked with a report - but it might have been a
custom.

What I have heard of is

1)       carrying an extra patient ID band in one's pocket to scan
(reportedly, the nurse believe this was OK because, after all, she was
scanning the patient's ID band)

2)       scanning the patient and med AFTER administration (reported to
me by a colleague recently hospitalized)

Sharon

 

  _____  

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Bowles, Jodi
Sent: Tuesday, June 26, 2007 8:53 AM
To: meditech-l@mtusers.com
Subject: [MEDITECH-L] eMAR/BMV

 

My facility is once again attempting to  start BMV and eMAR.  I have
noticed lots of inquires on the "L" regarding workarounds with BMV. Can
someone give an example of a "workaround". Is there anything that I can
do in the planning and teaching phase of eMAR and BMV to help decrease
workarounds?

Thanks

Jodi Bowles  RN, BSN

Clinical Systems Coordinator

Princeton West Virginia

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