Information Technology Reference
In-Depth Information
the wrong patient receiving medication, and (3) the user does not check or verify the
patient's new medication orders before administering medication, leading to wrong
medication dosage or administration route. The most prominent probable causes
are: (1) The scanning procedure is slower or more difficult than other methods
because it may conflict with workflow efficiency (Watanabe et al.
2006
; Tateishi
et al.
2008
), (2) Users are not well trained in using the adequate procedures, and
(3) Users are not aware of hospital medication use policies, e.g., double checking
for high-risk medications. In other words, from the viewpoint of BCMA,
practitioners act inappropriately; from the standpoint of human design, current
BCMA may be one of the worst products in the medical field, due to a lack of
sensitivity about human nature built into its design.
The PDA introduced from 2000 to 2007 cannot be said to be comfortable for the
nurse because its performance (Watanabe et al.
2006
), size and weight are far
behind the ideal form (Yano et al.
2008
). Windows CE-based terminals were
mainstream in those days, and these terminals had to expand to contain the high-
capacity battery and scanner modules needed to support longtime operation in the
ward. As a result, the size and weight of the terminal were increased to the point
where it was difficult to call it “mobile”. This became a major reason why nurses
did not want to effectively use BCMA. Other reasons to avoid BCMA include the
fact that the barcode is sometimes hard to scan, depending on the surface shape
(Yano et al.
2008
; Tateishi et al.
2008
); additionally, the pattern of the barcode may
be distorted, broken, or stretched.
Currently, most healthcare settings do not use the barcode labeled at the time the
product is shipped from the manufacturer, but use a barcode that the SPD (Supply
Processing Distribution) center or pharmaceutical department provides when it is
delivered to the healthcare setting. When drugs require refrigeration, the labels may
freeze and come off or condensation may blur the information (Yano et al.
2008
).
When the labels have to be re-labeled, there may be a chance that the wrong label is
applied. Some healthcare facilities re-label drugs after mixing an injection at a
ward. There may be also a possibility of mislabeling when the practitioner mixes
drugs for multiple patients at the same time.
6.3.1 RFID Overcomes the Problems of Barcode
It has been repeatedly pointed out that barcode authentication, relying on optical
technology, has usability problems: (1) A scanner's orientation and focus need to be
precisely oriented to the barcode, which requires great care, (2) Scratches, dirt, or
leaking fluids, such as blood, can make the barcode unreadable, (3) The barcodes on
a soft and deformable surface such as a wristband or intravenous feeding bags are
sometimes unreadable, (4) Attaching barcodes to a patient's body may disturb the
patient's sleep and rest. It may also upset patients because it detracts from their
individuality, (5) It requires scanning multiple barcodes to mix multiple injections,
(6) With traditional distribution processes, multiple barcode standards coexist and
