Survey of Nurses in a Neonatal Health Care Unit Regarding the Implementation, Use and Effectiveness of a Bar-Code Medication Administration System, Article Critique Example

Frank H. Morris Jr, Paul, W. Abramowitz, Lee Carmen, Anne B. Walis

The aim of the study was to identify intervening variables regarding the BCMA system. The study concentrated on identifying nurses’ opinions about the change in the process of administering medications and measures of their fidelity to the intervention. The authors of the study reported survey results and added them to their previous study of the effectiveness of BCMA system.

The authors of the study developed a 30 item survey, which included 10 items from the Nursing stress scale. Their aim was to measure stress from computer breakdown, fear of mistake when treating a patient, stress from feeling inadequately trained for the expected tasks, and uncertainty regarding operating specialized equipment in comparison to other stress-causing situations. The survey was electronic, anonymous and voluntary. The survey was available for four weeks approximately two years after the BCMA system was implemented in the hospital unit. There were 42 respondents to the survey.

The results were that most nurses learned to operate the BCMA system in two weeks or less. Almost all respondents believed that it reduced the number of medication errors and enhanced patient safety. Most respondents indicated that alerts were generated in approximately quarter of cases of administration, and were either “somewhat effective” or “usually effective”. Most nurses believed that administering medications took more time with BCMA system, and complained that it distracted them from other patient care tasks. Most respondents believed that BCMA system had a positive effect on nurse job satisfaction.

Narrative responses after the survey discovered that the nurses believed that was due to faulty equipment. They also revealed that nurses believed the limitations of the BCMA system were reliability of the equipment, bar codes that did not scan, and administration scheduling control by pharmacists who entered data to the system. This study is clinically significant as it provides the basis for devising guidelines on the implementation and use of the BCMA systems in healthcare settings and allows developing recommendations for nursing BCMA training programs. The authors provide significant theoretical support of their findings, and the relation of the theoretical framework to the study findings is explained.

The conclusions of the study are related to the findings, as they reflect the main results of the study. The authors concluded that the nurses believed that BCMA systems increased patient safety and nurse job satisfaction, but it took more time for medication administration, was not perfectly effective and could distract nurses from other tasks. The limitations of the study authors pointed were small participation rate and the fact that the study was single-site.

The evidence of clinical significance is compelling, as nurses complain that BCMA systems require more time for medication administration process, and are a distractive factor. Nevertheless, most nurses acknowledge that they enhance patient safety. The benefits of implementation BCMA are worth the risks, as, besides the decreased error level, most nurses report it increases their job satisfaction.

These findings are worthy to implement them in practice, as nurses are the main users of BCMA systems. The results of the similar studies give suchlike results, therefore, it is likely that most nurses experience similar problems with BCMA systems. Therefore, using the results of this study for developing equipment usage protocol and devising improvements to the system is justified.

Reference

Morris, F.H., Abramowitz, P.W., Carmen, L., &. Walis, A. B. (2009). “Nurses Don’t Hate Change” – Survey of nurses in a neonatal health care unit regarding the implementation, use and effectiveness of a bar code medication administration system. Healthcare Quarterly, 12, 135-140.