Improving Utilization of Bedside Scanning in an Emergency Department Setting: A Nursing-Pharmacy Path to Success

Purpose:
Background: Level II Trauma Emergency Department (ED), 19 beds, 24.4 RN FTE's, 1340 patients/month; MediTech scanning system in place. The scanning rate is doses scanned divided by doses given. Objective: A tiered approach to achieve and sustain 90% scan rate by July 1, 2008

Significance:
In the fast paced ED environment adding efficient use of technology to support nursing and pharmacy staff in patient care to reduce errors has become a critical element in our processes. Monitoring success, sustaining 90% threshold has become our standard, and practice that nurses hold accountable.

Strategy and Implementation:
April 2007-A report is finalized that produces a scan rate by unit, user or med.The ED is scanning 18% of all meds given.•Pharmacy Director(PD)taught ED manager how to run and analyze the report.•PD presents at ED staff meetings to discuss safety and accuracy advantages and establish process for staff to provide feedback to pharmacy on scanning issues.Pharmacy demonstrated a rapid response to identified issues and fixed them.May–December•ED manager and PD met on a regular basis to identify medications not scanned and individual staff trends.Medications not scanning addressed by pharmacy and ED manager coached non-compliant staff.•Goal of 50% set for staff on their 2007 annual evaluations.•ED is scanning 65% Jan-July 2008•Continued improvement,staff verbalize confidence in the scanning system and the value it adds to patient safety.ED is scanning at 79%.August-September•All staff scanning less than 80% are coached.•Individual scanning rates posted monthly at the nursing station.

Evaluation:
December•ED achieves 90% scan rate. The effectiveness of the innovation is measured by the rate of medication errors as well as the sustained rate of BMV scan rate use in the ED.

Implications for Practice:
This practice was deployed through the rest of the facility as well with additionally impressive results. The rate of medication errors has decreased proportionally with the increase in BMV scan rates.