Here are examples:
1) Scanning a barcode label instead of the patient's wristband when 
administering meds. The wrong patient can be given the meds when scanning a 
label. Some facilities have put an extra character on their wristbands so the 
barcode on the label won't work when documenting meds.
2) Scanning the first pill of a two pill dose, but not the second one. The dose 
can be changed manually by the user at the dose field without scanning the 
second pill. The danger in this practice is if the second pill is stocked 
incorrectly, the user won't know they gave the wrong drug. We had two similar 
name drugs stocked together in our Pyxis machine recently. Fortunately, the 
nurse noticed the error when she removed the drug, but if she had not scanned 
the second pill, she could have given the patient the wrong med.
3) Full documenting med administrations that should be scanned. Full 
documentation is a way to document without scanning the drug and should be used 
when documenting a med as not given or when a med doesn't have a barcode to 
scan. The safety features of barcoded meds is completely circumvented when this 
feature is used inappropriately.
 
Nurses that use workarounds are usually doing it for a reason. Workarounds are 
generally a symptom of a problem with the process or inadequate training. If 
nurses are scanning labels instead of patient's wristbands, it is usually 
because the wristband doesn't consistently scan. They typically won't tell you 
about the problem; they just find a workaround and go on with their day. That's 
just the nature of nurses-fix it and forget it! Watching for these workarounds 
will alert you to process problems or bad habits that need to be corrected.  
 


Kim Frick, RN 
Project Coordinator 
Licking Memorial Health Systems 
Phone: 740-348-4114 
Fax: 740-348-4769 
[EMAIL PROTECTED] 
www.LMHealth.org 
  

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Bowles, Jodi
Sent: Tuesday, June 26, 2007 10:53 AM
To: [email protected]
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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