[MT-L] bedside med verification
Stephanie Alford
How are other sites handling barcodes in order to prevent a user from scanning a patient label instead of the arm band for BMV? Do you have something in place to prevent this from happening?
If you are using an extra character on the labels, how do you resolve the issue of scanning the medical record that uses that label, with the extra character?
Appreciate all responses!
Stephanie Alford
MIS Project Coordinator
Information Systems
Peterson Regional Medical Center
551 Hill Country Drive, Kerrville, Texas 78028
o: 830-258-7572
f: 830-258-7321
sal...@petersonrmc.com
Notice: This communication, including attachments, is for the sole use of the intended recipient and may contain information that is confidential and privileged. The unauthorized use, dissemination, distribution, or reproduction of this e-mail, including attachments, is prohibited and may be unlawful. It constitutes non-public information intended to be conveyed only to the designated recipient(s). If the reader or recipient of this communication is not the intended recipient or an employee or agent of the intended recipient who is responsible for delivering it to the intended recipient, or if you believe that you have received this communication in error, please notify the sender immediately by return e-mail and promptly delete this e-mail, including attachments, without reading or saving them in any manner. Receipt by anyone other than the intended recipient(s) is not a waiver of any privilege.
Freeman, Gale
I believe we added extra characters to the normal admission labels, so they could not be used for BMV. It is account number that is scanned not the med rec, if I remember correctly?
My memory is fuzzy sometimes so I could be mistaken about that.
Gale
Paul Goedicke
We added a character to only the account number, which is what is scanned for BMV.
Paul Goedicke
Clinical Analyst III
Jackson County Memorial Hospital
1200 East Pecan
Altus, OK 73521
I will be out of the office Oct.27 through Nov. 8, 2016
Integrity is doing the right thing, even when no one is watching. C.S. Lewis
From: Meditech-l [mailto:meditech-...@mtusers.com] On Behalf Of Stephanie Alford
Sent: Tuesday, October 25, 2016 11:33 AM
To: 'medit...@mtusers.com'
Subject: [MT-L] bedside med verification
How are other sites handling barcodes in order to prevent a user from scanning a patient label instead of the arm band for BMV? Do you have something in place to prevent this from happening?
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HINES, SUSAN
We added the check digit to the Account # barcode on the wristband.
Thank you,
Susan A. Hines, RN, MSN
Nurse Informaticist
Calvert Memorial Hospital
Prince Frederick, MD 20678
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From: Meditech-l [mailto:meditech-...@mtusers.com]
On Behalf Of Freeman, Gale
Sent: Tuesday, October 25, 2016 12:39 PM
To: 'Stephanie Alford'; 'medit...@mtusers.com'
Subject: Re: [MT-L] bedside med verification
I believe we added extra characters to the normal admission labels, so they could not be used for BMV. It is account number that is scanned not the med rec, if I remember correctly?
My memory is fuzzy sometimes so I could be mistaken about that.
Gale
From: Meditech-l [mailto:meditech-...@mtusers.com]
On Behalf Of Stephanie Alford
Sent: Tuesday, October 25, 2016 12:33 PM
To: 'medit...@mtusers.com'
Subject: [MT-L] bedside med verification
How are other sites handling barcodes in order to prevent a user from scanning a patient label instead of the arm band for BMV? Do you have something in place to prevent this from happening?
If you are using an extra character on the labels, how do you resolve the issue of scanning the medical record that uses that label, with the extra character?
Appreciate all responses!
Stephanie Alford
MIS Project Coordinator
Information Systems
Peterson Regional Medical Center
551 Hill Country Drive, Kerrville, Texas 78028
o: 830-258-7572
f: 830-258-7321
sal...@petersonrmc.com
Notice: This communication, including attachments, is for the sole use of the intended recipient and may contain information that is confidential and privileged. The unauthorized use, dissemination, distribution, or reproduction of this e-mail, including attachments, is prohibited and may be unlawful. It constitutes non-public information intended to be conveyed only to the designated recipient(s). If the reader or recipient of this communication is not the intended recipient or an employee or agent of the intended recipient who is responsible for delivering it to the intended recipient, or if you believe that you have received this communication in error, please notify the sender immediately by return e-mail and promptly delete this e-mail, including attachments, without reading or saving them in any manner. Receipt by anyone other than the intended recipient(s) is not a waiver of any privilege.
Charles Still
You can get free wristband NPR Reports at PatientSafeRx.com in the downloads section..
Charles J. Still, MBA, CPPS, CPHQ
Preventing Workarounds to Barcoding at the Point of Care – Part 2. Wristbands
If there are other patient identifying barcodes in your environment that may be scanned to identify a patient to your BPOC system, they will at some point be scanned, bypassing a major component of the safety net that a correctly implemented system can provide.
Check Digit or other functionality may be used to prevent users from scanning labels other than the patient armband in a BMV environment.
Any barcode in the hospital environment that identifies a patient account number MAY be scanned in BMV to identify a patient to the system. This works great and is a safety enhancing operation when the barcode scanned is attached to a patient.
Unfortunately the simple circumvention of scanning patient labels away from the bedside can and will completely remove the entire safety net provided by BMV. If there are other scanable barcode labels in your environment, they will at some point be used to bypass scanning a patient armband.
To avoid this workaround in your environment you need to make sure that Other Patient Identifying labels are NOT Scannable by a barcode reader in your system. You also need to make your Wristbands easy to scan by using 2D Barcodes on them.
There are 3 main ways of making a NON Patient Armband unscannable.
Option 1. Add a Check Digit to ALL of your patient Labels.
Example: If your Patient Account Number is H123456789, you would append say an L to all of your patient labels so they would contain the data LH123456789
Result, scanning a patient label would not be a valid identifier to your other systems.
Fallout: You will need to program your LAB, Materials Management Barcode scanners to remove the L for scanning patient labels. You need to setup you scanning and archiving system to be able to see and remove the L from the barcode for paper document archiving. Be prepared to find out that your Blood Glucose reader users have been scanning the labels and not the patient armband.
Option 2 and 3 are a little less intrusive but rely entirely on being able to program your scanners to see / recognize a patient account number. I have talked with Hospital Systems that have accomplished this with Code Corp and Motorola and Symbol Scanners. Other vendors of “Smart” Barcode Scanners should be able to accomplish the same thing.
So again, if your patient account number is H123456789 you would program you scanner that an H followed by 9 Numeric Values is an ACCOUNT Number. Please note if your account number is numeric only this will not work.
Once your scanner recognizes that it is seeing an account number and NOT a medication label you have Option 2 and Option 3.
Option 2. Add a check digit to your Wristbands and make it required on the scanner. So again we could make our Wristband Account Number look like LH123456789. Your scanner would be programmed so that if it saw “LH” followed by 9 numeric values, that this is a Patient Account Number, it should then remove the L and forward the H123456789 to the computer. IF the scanner were to scan H123456789 it would have to have logic that said, This is an Account Number, there is no “L” Reject this scan as someone is trying to scan a patient label.
Fallout, you will need to leave a code 128 barcode on the armband for your blood glucose readers. You will not stop scanning of patient labels for blood glucose.
Option 3. Program your scanners to only read a patient account number if it is in a 2D barcode format. We would add 2D Datamatrix or Aztech, or QR Code encoded barcodes to your patient armband. We would then program the scanners to recognize that H followed by 9 numeric values, that this is a Patient Account Number. It would then check the barcode encoding. And if it were a Linear Code 128 barcode it would Reject this scan as someone is trying to scan a patient label.
Fallout, you will need to leave a code 128 barcode on the armband for your blood glucose readers. You will not stop scanning of patient labels for blood glucose.
Again the programming is key as many alt NDC’s are set as 10 digit numeric values. So you simply cannot require 2D only barcodes as most medications are (by law) code 128. Your scanners have to be intelligent enough to be programmed to read the data they are scanning and react accordingly if they see a patient account number.
The next thing you do need to do, is to setup a routine where you run an audit trail on RE-Printing Extra patient armbands. We setup a routine where we monitor ALL nursing armband reprints.
You could do this with the Meditech Audit report and I have it emailed to me 2 times a day and I manually review it for armband reprints. If I see a nurse prints more than 1 armband at a time, I forward the data to the Nursing Unit Supervisor for them to review.
Finally, I have also included the NAME of who printed a patient wristband and the date and time it was printed on every single armband. So if I were to find an armband not attached to a patient, nurse leadership could readily tell who printed it and find out why.
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Susan Iturbe
Stephanie, we use the custom NPR field to check digit given to me by Brian J Napier. I attached the custom field to the NPR report that prints the labels/wristbands. We use eAccess to print them.
Susana R. Iturbe
INFORMATICS ANALYST
P:(830)278-6251 ext. 1169
F: (830)591-0023
Uvalde Memorial Hospital ·
1025 Garner Field Road
· Uvalde, TX 78801
·
www.umhtx.org
Promoting the healing of those we serve by providing compassionate, high-quality healthcare.
From: Meditech-l [mailto:meditech-...@mtusers.com]
On Behalf Of Stephanie Alford
Sent: Tuesday, October 25, 2016 11:33 AM
To: 'medit...@mtusers.com'
Subject: [MT-L] bedside med verification
How are other sites handling barcodes in order to prevent a user from scanning a patient label instead of the arm band for BMV? Do you have something in place to prevent this from happening?
This message, together with any attachments, is intended only for the use of the individual or entity to which it is addressed and may contain information that is confidential and prohibited from disclosure. If you are not the intended recipient, you are hereby notified that any dissemination, or copying of this message, or any attachment, is strictly prohibited. Please notify the original sender immediately by telephone or by return e-mail and delete this message along with any attachments, from your computer. Thank you. This e-mail is Property of UMH.
Lynelle Boyd
We did the same.
Thanks,
Lynelle
Lynelle Boyd, RN
Clinical Information Systems Analyst
IT Department
Granville Health System
Stephanie Alford
So I assume you program the hand-held scanner to drop the first character. How does that affect your drug bar codes when you scan them? Do you re-label all meds when they are sent out of pharmacy?
Stephanie Alford
MIS Project Coordinator
Information Systems
Peterson Regional Medical Center
551 Hill Country Drive, Kerrville, Texas 78028
o: 830-258-7572
f: 830-258-7321
sal...@petersonrmc.com
From: HINES, SUSAN [mailto:shi...@cmhlink.org]
Sent: Tuesday, October 25, 2016 12:20 PM
To: 'Freeman, Gale'; Stephanie Alford; 'medit...@mtusers.com'
Subject: RE: bedside med verification
WARNING: This email originated outside of Peterson Health.
DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.
Paul Goedicke
Our scanners are programmed to identify the account number format with the extra character, which then drops the extra character. Drugs scan correctly without any changes because their barcode doesn’t match the account number. We use Code Corporation scanners and they have assisted us with scanner programming changes over the 8 or so years we have used them.
Paul Goedicke
Clinical Analyst III
Jackson County Memorial Hospital
1200 East Pecan
Altus, OK 73521
I will be out of the office Oct.27 through Nov. 8, 2016
Integrity is doing the right thing, even when no one is watching. C.S. Lewis
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The documents accompanying this transmission contain confidential information, belonging to the sender, that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information after its stated need has been fulfilled.
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Robin Ponton
Sent from my iPhone
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Do NOT send email to meditech...@MTUsers.com. This is a system email box that is NOT monitored by a human. If you need help or advice on how to use the meditech-l, email ju...@MTUsers.net. Julia helps manage the meditech-l, so she is your best resource.
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The information transmitted in this e-mail message and attachments, if any, may be attorney-client information, including privileged and confidential matter, and is intended only for the use of the individual or entity named above. Distribution to, or review by, unauthorized persons is strictly prohibited. All personal messages express views solely of the sender, which are not to be attributed to any organization. If you have received this transmission in error, immediately notify the sender and permanently delete this transmission including attachments.
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Do NOT send email to meditech...@MTUsers.com. This is a system email box that is NOT monitored by a human. If you need help or advice on how to use the meditech-l, email ju...@MTUsers.net. Julia helps manage the meditech-l, so she is your best resource.
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Chase, Margaret
We used the check digit on the armband, and it will not let user proceed with administration
Margaret M Chase, MSN, RN-BC
Senior Clinical Analyst
Ascension Information Services
Office number June 13, 2015: 202-854-7530
One Mission. One Integrated Ministry. One Ascension.
From: Meditech-l [mailto:meditech-...@mtusers.com]
On Behalf Of Stephanie Alford
Sent: Tuesday, October 25, 2016 12:33 PM
To: 'medit...@mtusers.com'
Subject: [MT-L] bedside med verification
How are other sites handling barcodes in order to prevent a user from scanning a patient label instead of the arm band for BMV? Do you have something in place to prevent this from happening?
CONFIDENTIALITY NOTICE:
This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
Stephanie Alford
Does it interfere with scanning of the bar code on the medication? I assume the scanner drops the check digit for the arm band, but how does it know the difference between the arm band and the med?
Stephanie Alford
MIS Project Coordinator
Information Systems
Peterson Regional Medical Center
551 Hill Country Drive, Kerrville, Texas 78028
o: 830-258-7572
f: 830-258-7321
sal...@petersonrmc.com
From: Chase, Margaret [mailto:Margare...@provhosp.org]
Sent: Tuesday, November 01, 2016 10:44 AM
To: Stephanie Alford; 'medit...@mtusers.com'
Subject: RE: bedside med verification
WARNING: This email originated outside of Peterson Health.
DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.
We used the check digit on the armband, and it will not let user proceed with administration