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Blood, sweat, tears, and breast milk?

October 27, 2010
by rjarvis
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Real world challenges with barcoding

Listening to our speakers on Tuesday's live webinar reminded me being a CIO involves myriad questions that often don't have anything to do with technology. At least it would seem so.

The topic was barcoding. Simple enough, right? Buy some scanners, print some labels, slap them on the patients and away you go. Yeah, right. Then there's that real world out there where the patients are not two-dimensional objects consisting of solely flat surfaces. Yeah, that. Then there are the challenges of the healthcare environment. Patients sometimes bleed on those barcodes. They sweat because they are under stress. The tags get wet. They can even come in contact with a range of bodily fluids that the manufacturers never considered, such as breast milk. Do you know if your tags can stand up to such? Have you ever tried asking your suppliers questions like that?

Barcoding and other ways to positively identify patients and match the right patient to the right medications are fast becoming a proven way to avoid adverse events. Medication errors remain a challenge for any healthcare organization and barcodes that match patient to medication are one tool in the quality improvement toolbox that are proven to work. But as speaker Charles Still of Southwestern Vermont Health Care noted, the best technology in the world does no good if the nurses don't consistently use the bar codes.

Throughout his organization, Still noted that code read rates are in the high 90-percent range. They have invested significant time in training and in making sure the technology works exactly as it should. That involved the infrastructure investment to have wireless systems with no dead spots and installation of thermal printers at the nursing units to make sure bar code wrist tags could be easily replaced if they became damaged. At the same time, they are able to monitor who is printing those tags to spot problems if patients' tags are lasting the duration of their stay.

This was, of course, not an overnight implementation. Still and the IT staff at SVHC had to work hard to make sure the nurses were aware of the changes coming and that they were sufficiently trained in use of the scanners. The 2D barcodes used in the facility made the reads more accurate and reliable but there were some problems to solve with other tags for glucose readers that were not compatible with the EMR but would sometimes read when scanned. Still discusses many strategies for how to avoid these problems in this webinar: Positive Patient ID: Barcoding Success at the Patient Bedside.

Still is joined by Kathleen Trotter from event sponsor Zebra Technologies. She discusses some of the pros and cons of various printer types while showing the audience how the thermal printers from Zebra provide some advantages for the healthcare environment. She also adds to Still's experience by discussing what other facilities have run into when implementing barcode readers. She stressed that "it all begins at the wrist" when it comes to making sure your choices will work in the real world. That would be the one of blood, sweat, tears and breast milk.

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