To Improve Patient Safety, Nurses Must Advocate for Better Informatics Tools
Health organizations increasingly are choosing medication administration technologies (MATs) to ensure the safety of patients, as well as to decrease liability for the organization. While these barcode readers are widely used and accepted, nurses must continue to strive to improve safety in medication administration. In an article that appeared in the Journal of Advanced Nursing
, researchers write, "While benefits of MATs appear promising, the implementation of healthcare technologies can also produce unintended consequences and new types of errors." For example, what happens if a nurse scans a medication and the barcode reader enters that same medicine twice, recording a double dose that didn't actually occur? Software that can recognize hardware errors can make these types of problems less likely.
Although hospitals are expected to meet national patient safety goals for medication administration, few, if any allow staff to provide input into the technologies they use to enhance productivity and patient safety. As a result, many nurses struggle unnecessarily with tools like barcode readers that are supposed to improve safety, reduce workload, and improve the daily working environment of nursing staff due to tools not functioning as intended. Barcodes are not error free. The scanners can fail to scan, misread a code, or send inaccurate information to the software; and vendors frequently change barcodes for different batches, causing mishaps when new stock becomes available to floor nurses.
There is also the question of whether MATs are truly evidence-based. In a report published in the American Journal of Health-System Pharmacy, researchers conclude, "The health care industry lacks scientific studies that validate technology and, when combined with best practices, improve patient safety by reducing medication errors."
Yet resolving medication errors is paramount to providing safe, quality care for all patients. Healthcare consumers should have confidence in a medical provider's ability to treat their problems to resolution while ensuring their safety. Nurses are in the middle between the organization and the patients and therefore must advocate for better tools.
Often nurses are so overwhelmed with tasks and duties that they have little time left to effectively advocate for change - they may simply state something is "not working," while providing little or no explanation. The technical staff is then left to figure out what is wrong and search for a solution. Nurses must provide more grass roots solutions. They can improve technology outcomes by providing specifics of problems, such as "this barcode reader will not read this particular label, but it reads these other labels." Even more important is for nurses to not simply accept a tool or technology and find a workaround, but rather to be an agent of change and advocate to hospital leaders and the IT department to discover better tools, processes, or methods to achieve the goals.
As nurses, we advocate for our patients even when we know there will be opposition. Bringing change to the workplace tools and technology requires this same type of fervor and commitment. Nurses are instinctive and resourceful in finding shortcuts and workarounds, but turning that same energy toward solving an issue - rather than working around it - will result in improvements not only in safety and patient care, but in the daily work environment we all experience. Informatics cannot provide any advantage unless information is collected, processed, and analyzed correctly. The only way for this to happen is by nurses being successful in using the tools provided.