Date of Award
College or School
College of Nursing
Program or Major
Pamela S. Kallmerten PhD, DNP, RN, CNL
Cathleen Colleran, DNP, RN
BACKGROUND: The Emergency Department (ED) is one of the busiest areas in the hospital. Patients are often acute, and it can get chaotic at times. Such a complex environment requires an effective and efficient system to increase staff efficiency and elevate patient safety. Patient and medication scanning has been a continuing issue with the current barcoding process using the in-room scanners and workstations on wheels (WOWs). In reviewing the Barcode Medication Administration (BCMA) weekly audit report, scanner broken and scanner not available are the most frequently used reasons for not scanning patients and medications. Additionally, WOWs can be hard to find or move around in areas without built-in scanners, especially during busy times. Adding mobile devices with the Rover™ Application for scanning patients and medications can address the abovementioned problems. The global aim is to improve patient safety and ED staff efficiency in barcoding patients and medications using the Rover™ Mobile app.
METHODS: The Plan-Do-Study-Act (PDSA) was used for this quality improvement (QI) project. A pre-intervention survey was sent out to staff to evaluate the current barcoding process and determine the perceived usability of in-room scanners/WOWs using the modified Technology Acceptance Model (mTAM) by Lewis (2019). mTAM was used to measure staff agreement regarding the products’ perceived usefulness (PU) and perceived ease of use (PEU). Similarly, a post-intervention survey was sent out a month after using the exact measurements. Qualtrics was used to analyze survey responses, including demographics, reasons for not scanning, frequency of use, and barriers to using the Rover™ app on mobile devices. Additionally, Qualtrics was used to compare the mean (M) and standard deviation (SD) of each of the twelve items in the mTAM. The specific aims include increasing staff’s patient and medication scanning compliance to 95% and above, decreasing occurrences of scanning noncompliance due to scanners broken and unavailable, and improving staff’s perception of usefulness and ease of use with the Rover™ mobile app.
RESULTS: There was a substantial increase in the staff’s perceived usefulness and ease of use with the Rover™ app on mobile devices. Perceived usefulness increased from a Mean of 3.73, SD of 1.09, Range 1-5 with the in-room scanners/WOWs to a Mean of 4.03, SD 1.17, Range 1-5 with the Rover™ app on mobile devices. Similarly, perceived ease of use increased from a Mean of 3.58, SD 1.28, Range 1-5 with the in-room scanners/WOWs to a Mean of 3.73, SD 1.29, Range 1-5 with the Rover™ app on mobile devices. In the first week of March, medication scanning compliance was 82%, and patient scanning compliance was 83%. With the addition of the Rover™ app on mobile devices, patient scanning compliance has peaked at 93-94%, while medication scanning stayed above 90% in most weeks. Concurrently, the reasons for not scanning per policy have also declined with using the Rover™ app. Before the intervention, the choice of scanner broken was provided 66 times, while scanner not available was the reason provided 262 times. In September, the scanner broken reason decreased to 31, and the scanner not available reason decreased to 78.
CONCLUSION: Although the desired benchmark of 95% for patient and medication scanning compliance was not achieved, the Rover™ app on mobile devices remarkably helped increase staff compliance with medication and patient scanning and has decreased the use of scanners broken and unavailable as reasons for not scanning. There are many external variables to consider, but most notably, having a clear use case for any QI initiative is integral. Unit leadership should set expectations and hold staff accountable for noncompliance. This QI project was instrumental in increasing staff efficiency with patient and medication scanning and introducing the added features of the Rover™ app on mobile devices, including scanning lab specimens, secure chat, and Webex calling. The desired goal of 95% staff compliance would be easily achieved as more and more Rover™ app features are added, and staff become more adept in using and integrating the new technology into their daily care of patients.
Kirit, Ian, "Improving Patient Safety and Emergency Department Staff Efficiency in Barcode Medication Administration by Using the Rover™ Mobile Application" (2023). DNP Scholarly Projects. 94.