Use of Bar-coded Medication Administration Technology to Enhance Quality and Safety Standards in Nursing – Annotated Bibliography

Annotated Bibliography on Technology in Nursing – Assignment Instructions

Write a 4-6 page annotated bibliography where you identify peer-reviewed publications that promote the use of a selected technology to enhance quality and safety standards in nursing.


Rapid changes in information technology go hand-in-hand with progress in quality health care delivery, nursing practice, and interdisciplinary team collaboration. The following are only a few examples of how the health care field uses technology to provide care to patients across multiple settings:

  • Patient monitoring devices.
  • Robotics.
  • Electronic medical records.
  • Data management resources.
  • Ready access to current science.

Technology is essential to the advancement of the nursing profession, maintaining quality care outcomes, patient safety, and research.

This assessment will give you the opportunity to deepen your knowledge of how technology can enhance quality and safety standards in nursing. You will prepare an annotated bibliography on technology in nursing. A well-prepared annotated bibliography is a comprehensive commentary on the content of scholarly publications and other sources of evidence about a selected nursing-related technology. A bibliography of this type provides a vehicle for workplace discussion to address gaps in nursing practice and to improve patient care outcomes. As nurses become more accountable in their practice, they are being called upon to expand their role of caregiver and advocate to include fostering research and scholarship to advance nursing practice. An annotated bibliography stimulates innovative thinking to find solutions and approaches to effectively and efficiently address these issues.

Annotated Bibliography on Use of Bar-coded Medication Administration Technology to Enhance Quality and Safety Standards in Nursing

The selected technology is bar-coded medication administration (BCMA) technology. This is a technology used by nurses in health care organizations to reduce medication administration errors through electronic verification of the five rights of administrations of medication. These include the right route, right patient, right time, right dose, and right drug at the bedside of a patient (Shah et al., 2016). The annotated bibliography features different research articles focusing on assessing the effectiveness of this technology in reducing errors in medication administration, and factors that influence the levels of errors or variation in levels of errors in different health care settings.

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Baiden, D. (2018). Factors affecting the impact of barcode medication, administration technology in reducing medication, administration errors by nurses. Canadian Journal of Nursing Informatics, 13(1), 1-12.

In this article, Baiden (2018) assesses and reviews literature on the aspects influencing the effect of BCMA technology in lowering medication errors in hospital settings by nurses. Baiden (2018) used the socio-technical model as the conceptual framework. The BCMA impact in lowering errors in medication administration was found to differ based on various factors including nurse associated issues, technology associated setbacks, and clinical settings. Aspects contributing to this variation included system monitoring and measurement, software and hardware computing infrastructure, pressures and regulations, clinical content, external rules, human-computer interface, culture and procedures, people, communication and workflow, as well as internal organization policies. This article informs nurses and nurses informatics on the importance of regulating the eight internal and external factors that influence BCMA performance, for better results.

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Boonen, M. J. M. H., Vosman, F. J. H., & Niemeijer, A. R. (2016). Tinker, tailor, deliberate. An ethnographic inquiry into institutionalized practice of bar-coded medication administration technology by nurses. Applied Nursing Research, 33, 30-35. 

In this article, Boonen, Vosma and Niemeijer (2016), conducted research to explore the nursing practice for nurses operating BCMA with the intention of understanding its effect on their work. The research was founded on the claim that BCMA effectually lowers the quantity of errors in medication dispensed to patients. The main intention of the research was to determine whether this does happen in actual practice. The researchers employed institutional praxeology and ethnography research methodology to uncover the BCMA complex practice by nurses. The research results demonstrated that the BCMA implementation created a number of issues resulting in constant tinkering of the technology by nurses. Simultaneously, they were unceasingly deliberating the best techniques of tailoring the BCMA to all their patients. The research concluded that although operating BCMA is frequently misinterpreted as being automatic and mindless, technology conformity is needed as the tinkering with BCMA normally entails comprehensive consideration by nurses. This article will be used to inform nurses about the importance of learning a technology for effective use.      

Kandace, K., Linda, H., Pat, M., Barbara, T., & Constance, J. (2016). Creating a culture of safety around bar-code medication administration: an evidence-based evaluation framework. JONA: Journal of Nursing Administration, 46(1), 30-37.

In this article, Kandace et al. (2016) develop a BCMA technology 4-phased evaluation program to assess the level of current technology integration into BCMA practices, procedures, and policies. The aim of this evaluating was to identify the barrier to the use of BCMA best-practice. The program offered a framework for frontline nurses to make an alliance with hospital leaders to progressively improve and evaluate BCMA by use of systematic processes. The evaluation established that the effectiveness of BCMA is contingent on compliance with protocols of best practice. This article will be used to inform nurses on the best way to ensure BCMA efficiency and how they can be propagated through partnership with organization leaders and by employing continuous systematic improvement process that combines new evidence-base practice to guarantee safety in medication administration. 

Seibert, H. H., Maddox, R. R., Flynn, E. A., & Williams, C. K. (2014). Effect of barcode technology with electronic medication administration record on medication accuracy rates. American Journal of Health-System Pharmacy, 71(3), 209-2018.

In this article, Seibert, Maddox, Flynn and Williams (2014) conduct research to evaluate the BCMA effect with electronic medication administration record (eMAR) technology on error occurrence in medication administration. A posttest-pretest nonequivalent assessment group was utilized in examining the BCMA-eMAR effect on the accuracy rate of medication administration at two community-founded hospitals. The results demonstrated that the general rate of accuracy at hospital 1 significantly increase from 89% in the first phase of implementation to 90% in the third phase of technology implementation. Hospital two also experienced a 3% increase in accuracy rate from what was recorded in phase one to what was recorded in phase 3, with the final accuracy rate being 96%. It was concluded that BCMA-eMAR implementation in the two hospitals resulted in a significant increase in total accuracy rate in medication administration, and did not introduce any new form of error into the process of medication administration. This article will inform nurses and healthcare organizations on the important of BCMA technology in enhancing medical safety and the importance of integrating eMAR in BCMA for more improved results.

Shah, K., Lo, C., Babich, M., Tsao, N. W., & Bansback, N. J. (2016). Bar code medication administration technology: a systematic review of impact on patient safety when used with computerized prescriber order entry and automated dispensing devices. The Canadian Journal of Hospital Pharmacy, 69(5), 394-402.

In this article, Shah et al. (2016), conduct a systematic review of the literature published between 1992 and 2015 on how BCMA technology influence patient safety when implemented with automated devices for dispensing and prescriber order entry using a computer. The researchers evaluated 37 articles that met their research purpose after employment of inclusion and exclusion criterion. According to the assessment, there is limited comparative evidence offering BCMA justification with its complementary technologies. About 5 studies in the review proposed that BCMA contains the ability to lower total medication errors, transcription errors, and administration errors. Its effect on wrong time errors is unclear. BCMA was also found to contain the ability to enhance compliance with the need to check the identity of the patient prior to medication administration and to chart medication administration on the MAR. This research will inform the nurses on the importance of BCMA in reducing medication errors and also inform on research gaps that they can focus to gain more evidence on BCMA technology in the administration of medicines.

Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens. J. M. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342-351.

In this article, Thompson et al. (2018) conduct research to evaluate the effect of BCMA technology implementation on the rate of errors in medication administration in an inpatient environment, particularly those that cause harm to the patient. The analysis involved assessing cases of reported medication-associated adverse incidences for over 12 months before BCMA implementation and five years during the 11 separate BCMA implementation waves. Only actual errors were considered. The assessment results demonstrated that there was a decline of 43.5% of reported errors in medication administration, after BCMA technology implementation. The rate of errors associated with harmful medication declined by 55.3%. There were no extreme errors created by BCMA factors. This research concluded that BCMA’s consistent use enhances patient safety by lowering the quantity of harmed patients by errors involving medication administration. This article is used to demonstrate the benefits of BCMA technology when effectively employed in nursing practice.

Truitt, E., Thompson, R., Blazey-Martin, D., Nisai, D., & Salem, D. (2016). Effect of the implementation of barcode technology and an electronic medication administration record on adverse drug. Hospital Pharmacy, 51(6), 474-483.

In this article, Truitt et al. (2016) conduct a research study to assess the effects of BCMA and eMAR technology on adverse drug events (ADEs) profile in a hospital environment. Truitt et al. (2016) conducted an after-and-before study examining the effects of the said technology on ADEs profile at a teaching medical center with 400-bed using incident reports. The ADEs report in 5 months post- and pre-implementation periods were compared to establish if there was ADEs rate reduction in the phases’ medication use. The searchers also assessed the error severity and alterations in the distribution of error types. The results of the research demonstrated a decline in ADEs after technology implementation and transcription errors, although the administration error remained constant. There was also a considerable decline in the administration errors’ severity level. Implementation of BCMA and eMAR was found to improve patient safety a great deal.  This article is used to inform nurses on specific improvements BCMA-eMAR improves and what one should focus on as an individual for the best outcome.

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