The Efficacy of Patients’ Wristband Bar-code on Prevention of Medical ErrorsA Meta-analysis Study
26 July 2015
accepted in revised form: 06 October 2015
19 December 2017 (online)
Background: Patient misidentification, as a major patient safety issue, occurs in any healthcare setting and leads to inappropriate medical procedures, diagnosis or treatment, with serious outcomes.
Objectives: The study aimed to investigate the effectiveness of wristband bar-code medication scanning to reduce medical errors (ME).
Methods: A meta-analysis study was conducted. The relevant studies were searched in PubMed, Embase, Cochrane Library, Web of Science and Scopus from 1990 to March 2015. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria. Data were extracted, and the quality of the included studies was evaluated using the STROBE checklist.
Results: In total, 14 articles involving 483 cases were included. The meta-analysis indicated that the use of wristband bar-code medication scanning can reduce the ME around 57.5% (OR=0.425, 95% CI: 0.28-0.65, P<0.001). The study results showed a marked heterogeneity in the subgroup analysis (I-squared=98%). This was I2=70.35, P-value=0.018 for the type of samples and I2=99%, P-value<0.001 for years and countries.
Conclusion: Wristband bar-code medication scanning can decrease the ME in hospital setting. Since the patient’s safety is the main goal of the World Health Organization, it is recommended that a unique patient identification barcode should be used with name, medical record number, and bar-coded financial number.
- 1 DeYoung JL, Vanderkooi ME, Barletta JF. Effect of bar-code-assisted medication administration on medication error rates in an adult medical intensive care unit. Am J Health Syst Pharm 2009; 66 (12) 1110-1115.
- 2 Dhatt GS, Damir HA, Matarelli S, Sankaranarayanan K, James DM. Patient safety: patient identification wristband errors. Clin Chem Lab Med 2011; 49 (05) 927-929.
- 3 Zarbo RJ, Tuthill JM, D’Angelo R, Varney R, Mahar B, Neuman C, Ormsby A. The Henry Ford Production System Reduction of Surgical Pathology In-Process Misidentification Defects by Bar Code–Specified Work Process Standardization. Am J Clin Pathol 2009; 131 (04) 468-477.
- 4 Valenstein PN, Raab SS, Walsh MK. Identification errors involving clinical laboratories. Arch Pathol Lab Med 2006; 130 (08) 1106-1113.
- 5 Snyder SR, Favoretto AM, Derzon JH, Christenson RH, Kahn SE, Shaw CS, Baetz RA, Mass D, Fantz CR, Raab SS, Tanasijevic MJ, Liebow EB. Effectiveness of barcoding for reducing patient specimen and laboratory testing identification errors: a Laboratory Medicine Best Practices systematic review and meta-analysis. Clin Biochem 2012; 45 (13) 988-998.
- 6 Morrison AP, Tanasijevic MJ, Goonan EM, Lobo MM, Bates MM, Lipsitz SR, Bates DW, Melanson SE. Reduction in specimen labeling errors after implementation of a positive patient identification system in phlebotomy. Am J Clin Pathol 2010; 133 (Suppl. 06) 870-877.
- 7 Porcella A, Walker K. Patient safety with blood products administration using wireless and bar-code technology. AMIA Annu Symp Proc 2005: 614-618.
- 8 Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, Moniz T, Rothschild JM, Kachalia AB, Hayes J, Churchill WW, Lipsitz S, Whittemore AD, Bates DW, Gandhi TK. Effect of bar-code technology on the safety of medication administration. N Engl J Med 2010; 362 (18) 1698-1707.
- 9 Hayden RT, Patterson DJ, Jay DW, Cross C, Dotson P, Possel RE, Srivastava DK, Mirro J, Shenep JL. Computer-assisted bar-coding system significantly reduces clinical laboratory specimen identification errors in a pediatric oncology hospital. J Pediatr 2008; 152 (02) 219-224.
- 10 Howanitz PJ, Renner SW, Walsh MK. Continuous wristband monitoring over 2 years decreases identification errors: a College of American Pathologists Q-Tracks Study. Arch Pathol Lab Med 2002; 126 (07) 809-815.
- 11 Helmons PJ, Wargel LN, Daniels CE. Effect of bar-code-assisted medication administration on medication administration errors and accuracy in multiple patient care areas. Am J Health Syst Pharm 2009; 66 (13) 1202-1210.
- 12 Poon EG, Keohane C, Featherstone E, Hays B, Dervan A, Woolf S, Hayes J, Bane A, Newmark L, Gandhi TK. Impact of barcode medication administration technology on how nurses spend their time on clinical care. AMIA Annu Symp Proc. 2006: 1065.
- 13 Askeland RW, McGrane SP, Reifert DR, Kemp JD. Enhancing transfusion safety with an innovative bar-code-based tracking system. Healthc Q 2008; 12: 85-89.
- 14 Morriss FH, Abramowitz PW, Nelson SP, Milavetz G, Michael SL, Gordon SN, Pendergast JF, Cook EF. Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study. J Pediatr 2009; 154 (Suppl. 03) 363-368.
- 15 Murphy MF, Casbard AC, Ballard S, Shulman IA, Heddle N, Aubuchon JP, Wendel S, Thomson A, Hervig T, Downes K, Carey PM, Dzik WH. Prevention of bedside errors in transfusion medicine (PROBE-TM) study: a cluster randomized, matched paired clinical areas trial of a simple intervention to reduce errors in the pretransfusion bedside check. Transfusion 2007; 47 (05) 771-780.
- 16 Paoletti RD, Suess TM, Lesko MG, Feroli AA, Kennel JA, Mahler JM, Sauders T. Using bar-code technology and medication observation methodology for safer medication administration. Am J Health Syst Pharm 2007; 64 (05) 536-543.
- 17 Franklin BD, O’Grady K, Donyai P, Jacklin A, Barber N. The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study. Qual Saf Health Care 2007; 16 (04) 279-284.
- 18 Sakowski J, Leonard T, Colburn S, Michaelsen B, Schiro T, Schneider J, Newman JM. Using a bar-coded medication administration system to prevent medication errors in a community hospital network. Am J Health Syst Pharm 2005; 62 (24) 2619-2625.
- 19 Johnson CL, Carlson RA, Tucker C, Willette C. Using BCMA software to improve patient safety in Veterans Administration Medical Centers. JHIM 2001; 16 (01) 46-51.
- 20 Stevanovic A, Coburn M, Rossaint R. Minimum requirements for high quality reporting of medical research results: CONSORT, STROBE and PRISMA statements. Anaesthesist 2015; DOI10.1007/s00101–015–0085–8 [uni25A0][Epub ahead of print]
- 21 Mayo NE, Gloutney L, Levy AR. A randomized trial of identification bracelets to prevent falls among patients in a rehabilitation hospital. Arch Phys Med Rehabil 1994; 75 (12) 1302-1308.
- 22 Ohsaka A, Furuta Y, Ohsawa T, Kobayashi M, Abe K, Inada E. Bar code-based pre-transfusion check in pre-operative autologous blood donation. Transfus Apher Sci 2010; 43 (02) 183-188.
- 23 Keohane CA, Bane AD, Featherstone E, Hayes J, Woolf S, Hurley A, Bates DW, Gandhi TK, Poon EG. Quantifying nursing workflow in medication administration. J Nurs Adm 2008; 38 (01) 19-26.
- 24 Brown JE, Smith N, Sherfy BR. Decreasing mislabeled laboratory specimens using barcode technology and bedside printers. J Nurs Care Qual 2011; 26 (01) 13-21.