[MT-L] Scanning of stickers instead of wristbands

[Dorsie Sullenger]

I apologize if the answer to this question has been posted many times. We have problem with nursing taking shortcuts and scanning the stickers instead of wristbands. Is there somewhere I should go that would show me previous postings of how to resolve this issue? I assume you can change the barcode on the stickers so that the BMV system would not work on these. Any help would be much appreciated. Our IS department tells us this cannot be done. They claim the stickers must be just like the wristband.

Thank you

Dorsie Sullenger

Mr. Dorsie Sullenger RPh.
Director of Pharmacy
Madison Memorial Hospital
450 East Main
Rexburg, ID 83440
208-359-6484
Fax: 2083599826

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[Still, Charles]

I emailed you some notes directly...

Basically if you allow scanning of labels, you may as well not implement
Bedside Scanning. Take all the money you would have spent on scanning
and equipment and put it in your legal defense fund for the inevitable
error that hurts someone.

Your scanners can be programmed to only accept input from armbands a
number of ways. Or you can add check digits to your labels and then
program for it in your Paper Scanning system, then the labels cannot be
scanned for patient ID.

We added a check digit to all of our labels so they could no longer be
scanned for Blood Glucose or Bedside Med scanning. On one label sheet
of 32 labels, I missed 2. Within a week the labels were found and used
instead of an armband. I fixed them.

We also monitor our armband printing trail and print the name of WHO
PRINTED on the armband itself in case we find one floating about.

Charles J. Still, MBA
Southwestern Vermont Health Care
Information Services
100 Hospital Drive
Bennington, VT 05201
phone 802 447 5107 fax 802 447 5495
email st...@phin.org
website www.svhealthcare.org

Thank you

Dorsie Sullenger

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[Curtiss, John L]

There have been several solutions posted which can be best summarized as there needs to be some variation between the bar code on the patient label and on the wrist band. The variation can be a bar code format or a special character. Most bar code scanners can be programmed to perform some form of character substitution or addition based upon recognizing a format or a character. I realize the previous sentence vague; the solution really depends on the bar code scanner being used. If possible you want to standardize the bar code scanners being used in the patient rooms so you don't have to come up with multiple solutions. The scanners used in the patient rooms don't have to be the same as other areas.

John Curtiss
Hutchinson Area Health Care
1095 Highway 15 South
Hutchinson, MN  55350
 
320-484-4440 (work) << Note, changed on March 10, 2010
320-234-4637  (fax)
jcur...@hahc-mn.org
 

-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Dorsie Sullenger
Sent: Tuesday, June 22, 2010 10:54 AM
To: medit...@mtusers.com
Subject: [MT-L] Scanning of stickers instead of wristbands

[Furbush,Debra]

We chose to place a different barcode on the armband than on our sheet of patient labels. On the patient labels (which they use for labeling order sheets, etc) is a concatenated barcode of the account number and the medical records number. I works great.

Debra Furbush
Applications Coordinator, Information Services
Blanchard Valley Health System/CareTech Solutions
1900 S. Main Street
Findlay, OH 45840
Office: 419-423-5529 Cell: 419-306-5743
dfur...@bvhealthsystem.org
"Whatever it Takes!"

"Optimists enrich the present, enhance the future, challenge the improbable, and attain the impossible." - William Arthur Ward

[Maria Clause]

There is a KB article on the Meditech Website which describes how to use the check digit on the wristband so that it differs from other bar codes.

KB Article # 28987

Many sites have asked about making the patient wristband a unique identifier for BMV. In versions 5.5 and 5.6, BMV accepts a scan of any bar code of the account number. Charts are often filled with bar coded stickers intended to label lab specimens, etc. Nurses are therefore able to use any of these labels to "verify" the patient in BMV. Sites are concerned that the wrong label in the wrong chart could result in a medication error for wrong patient. They want end users scanning only the bar code that is on the wristband the patient is wearing.

MEDITECH software currently can offer no solution to sites for this user compliance issue. However, several sites are now LIVE with a solution to this issue using custom scanner programming to achieve a "unique" patient wristband. In order to achieve this, a site must customize the wristband bar code so that the account number that is bar coded on the wristband differs from the account number that is bar coded on the other labels. From here, a site can then program the scanners to "parse" the scanner input before passing it on to MT.

NOTE: IT IS CRITICAL THAT any effort to use scanner programming to achieve bar code uniqueness has to be coded so that the programming does not parse or otherwise interfere with the reading and transmitting of Rx and NDC bar code identifiers!

The setup for this capability will vary by scanner make and model. Also, only scanners that offer custom programming functionality can be used to achieve this effect. One site has set up the parsing as follows:

The account number is two alpha characters followed by ten numeric characters, as follows:

AANNNNNNNNNN

When they produce the wristband and other labels in Admissions, they manipulate the output as follows:

Wristbands: $$AANNNNNNNNN (They are prefixing the Acct # with two ASCII characters)

Other labels: AANNNNNNNNNN

When the scanner reads the above input, it has been custom programmed as follows:

$$AANNNNNNNNN: Strip the ASCII characters ($$), pass the rest to MT as AANNNNNNNNNN

AANNNNNNNNNN: Substitute a "0" for the second alpha character and pass to MT as A0NNNNNNNNNN

When the genuine wristband input is passed to MT, BMV therefore accepts it as Acct# input and tries to match it as a patient scan. Appropriate messages are then displayed. The following output is possible after scanning the wristband bar code ($$AANNNNNNNNN)

Where system expects PT > System finds match or says "Wrong PT. May not continue."

Where system expects Rx/NDC > System says "You scanned Acct.#. Please scan Rx/NDC."

When the input from the other labels is passed to MT, the system mistakes it for an NDC number, and prompts the user based on the presumption that it is getting an Rx/NDC scan. The following output is possible after scanning the other bar coded labels (AANNNNNNNNNN)

Where the system expects PT > System says "You scanned Rx/NDC. Scan PT."

Where the system expects Rx/NDC > System says "Medication not on profile."

When the input from an Rx or NDC is passed to MT, the system is unaffected by the scanner programming.

ADDITIONAL NOTE: The ASCII characters should be unprintable characters so that nurses cannot manually enter the special bar code.

Maria Clause

Information Services Department

Thibodaux Regional Medical Center

602 North Acadia Road

Thibodaux, LA 70301

Office: (985) 435-4825

Cellular: (985) 414-1485

maria....@thibodaux.com

-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Curtiss, John L
Sent: Tuesday, June 22, 2010 2:03 PM
To: Dorsie Sullenger; medit...@mtusers.com