Transcript Changes-in-Work-Flow-for-Faculty-Supervising-Stude

CHANGES IN WORK FLOW FOR
FACULTY SUPERVISING STUDENTS
IN A CLINICAL SETTING AS A
RESULT OF BAR CODE
MEDICATION ADMINISTRATION
Ann Carruth, Dean College of
Nursing and Health Sciences
Eileen Creel, Department Head,
School of Nursing
BACKGROUND
 IOM (1999), reported nearly a million patients each year are injured in
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hospitals in the U.S. due to medication error. Bar coded medication
administration systems (BCMA) are one of the proposed solutions to
medication administration errors and may reduce reported medication
errors by as much as 86%.
Bar coded medication administration has significantly changed nurses
workflow processes.
BCMAs were intended to eliminate “work arounds” which contribute to
mediation errors. However, this has not been fully realized and new work
around have been developed.
With the integration of new electronic technologies in the clinical setting,
policies to guide nursing instructors who supervise students in medication
administration may not be meeting current needs.
No studies have addressed workarounds used by nursing faculty in the
supervision of student nurses medication administration fusing BCMAs.
 Various policies impact faculty instruction: Medication administration
policy, automatic dispensing machine (ie: PIXIS) policy; electronic health
records policy, bar code medication administration process policy. These
are unique to each agency.
 Many agencies do not have a policy specific to student medication
administration.
 Research on the impact of the changes related to supervision of nursing
student medication administration by faculty in the clinical setting is
limited. A survey by Reid-Searl (2013) suggests that legal requirements
surrounding nursing student medication administration are not being
met.
METHODS
 A descriptive cross sectional survey method was used to better
understand the current use, processes, and policies in practice today by
nursing faculty supervising nursing students in clinical settings. An email
invitation was sent to participate in an online survey using
SurveyMonkey.
 All Dean’s or Directors listed on the LACANE roster were emailed to
participated in the survey. was used to send 531 emails to B. S. and A.D.
programs in 45 states.
 CCNE and ACEN site visitor lists were used to randomly select B.S. and
A.D. programs nationally.
 267 B.S programs in 42 states and 264 A.D. programs in 45 states were
invited to participate.
ARE STUDENTS GIVEN A UNIQUE
BADGE/BARCODE OR ACCESS CODE TO
DOCUMENT MEDICATION ADMINISTRATION IN
THE EHR?
ARE STUDENTS GIVEN A BAR CODE/BADGE OR
ACCESS CODE TO RETRIEVE MEDICATION FROM
THE MEDICATION DISPENSING MACHINE?
WHICH STATEMENT BEST REFLECTS THE
SITUATION OF RETRIEVING MEDICATIONS
FROM MEDICATION DISPENSING MACHINES?
WHICH STATEMENT BEST REFLECTS THE
PROCESS OF MEDICATION ADMINISTRATION?
DOES YOUR AGENCY HAVE A POLICY FOR
MEDICATION ADMINISTRATION BY STUDENTS
SEPARATE FROM A GENERAL POLICY ON
MEDICATION ADMINISTRATION?
WHICH OF THE FOLLOWING REFLECTS YOUR
SITUATION WITH MEDICATION
ADMINISTRATION?
HAVE ANY OF YOUR STUDENTS HAD A DRUG
ERROR OR NEAR-MISS DRUG ERROR USING
BARCODE MEDICATION ADMINISTRATION
(BCMA) SYSTEMS?
IF YES TO PREVIOUS QUESTION, WHICH OF THE
FOLLOWING WERE CONTRIBUTING FACTORS?
YOUR AGE FALLS IN WHICH RANGE?
IMPLICATIONS & RECOMMENDATIONS
 Age and technology
 Senior students are more likely to be given bar code access badges, however all
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level of students are administering medications. Clinical facilities should broaden
access to BCMA codes for all persons engaged in mediation administration.
Development of medication administration policies by hospitals to include
student nurse in the BCMA process with input from clinical faculty involved in
processes.
Additional research into the extent that faculty are engaged in work-arounds –
and if they are aware these are work-arounds.
Schools of Nursing should review/consider the legal implications for supervision
of nursing students engaged in medication administration with new technologies.
(i.e.: when the chart does not reflect the student nurse’s name as the person
administering the medication – is this falsification of medication record?
LSBN considers this falsification of the medical record.