Date of Award

Summer 2022

Project Type

Thesis

College or School

CHHS

Department

Nursing

Departments (Collect)

Nursing

Program or Major

Direct Entry Masters of Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Abstract

Background: In the landmark report To Err is Human: Building a Safer Health System published by the Institute of Medicine in 1999, it was estimated that 98,000 Americans die annually due to medical mistakes (Institute of Medicine et al., 2000). Since then, major advancements have been made to improve patient safety in the United States relating to safe medication administration. Barcode medication administration (BCMA) is a technology that was designed to help decrease medication errors by automating the five rights of medication administration (Thompson et al., 2018). BCMA was first utilized at a Veteran Affairs (VA) Medical Center in Topeka, Kansas in 1995, and by 2002, all VA Medical Centers were utilizing the new technology (Office of Public and Intergovernmental Affairs, 2002). At a VA Medical Center in the northeastern United States, BCMA is being utilized in most units of the medical center except for the post-anesthesia care unit (PACU) in the Same-Day Surgery (SDS) center. Resistance to change is believed to be one of the barriers to the implementation of the BCMA in the microsystem.

Global Aim: In this quality improvement project, the global aim is to improve patient safety in the VA Medical Center’s PACU by identifying the nurses’ perceived barriers to the implementation of BCMA and decreasing resistance to change by providing evidence-based education about safe medication administration.

Methods: The registered nurses’ perceived barriers were identified using a survey (n=7) based off of the Technology Acceptance Model (Venkatesh & Bala, 2008). The education provided to the nurses directly targeted the perceived barriers identified in the pre-intervention survey and included only evidence-based research. The nurses were re-surveyed after the educational intervention to determine if the education impacted their perception of the usefulness of BCMA.

Results: After the educational session, the nurses were more likely to perceive BCMA as useful when administering medication, reducing its likelihood of being a barrier to implementation. Although the perceived usefulness of BCMA increased among the nurses, perceived barriers still existed post-intervention and included BCMA causing medication administration to be slower and more difficult, as well as perceived reduction in productivity when caring for patients. The nurses also identified additional barriers, such as pharmacy staff availability during PACU operating hours, and the need for additional mobile computers on the unit.

Conclusion: Future efforts to address these perceived barriers can improve patient safety during the medication administration process in the microsystem.

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