Date of Degree
Fall 2024
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Sandra Cleveland
Second Advisor
Dr. Amanda Graham
Third Advisor
Dr. Melanie Brewer
Abstract
Problem: In the project organization, a large ambulatory medical group, there have been high rates of vaccine administration errors, particularly within family practice locations, which have the most variety of vaccines given.
Aim of the Project: This project aimed to improve the safety of vaccine administration by implementing barcode medication administration (BCMA) in two family practice locations.
Review of the Evidence: BCMA is increasingly recommended for outpatient settings by patient safety groups like the Institute for Safe Medication Practices (2022). Studies show BCMA can save time, improve vaccine data capture and can decrease medication errors by up to 74% (Evanson et al., 2020; Holder et al., 2021; Owens et al., 2020).
Project Design: This project utilized the Institute for Healthcare Improvement’s "Model for Improvement" framework and the OhioHealth Change Management Model. Plan-do-study-act cycles guided BCMA workflow development, while OhioHealth's model engaged stakeholders in the transition (IHI, n.d.; OhioHealth, 2021). Vaccine error rates and clinic throughput times were monitored before and after implementation and medication scan rates and compliance with workflow were measured after BCMA go-live to measure project results.
Intervention: This QI project implemented BCMA in two family practice offices. Site A was selected due to its proximity to Site B and its lower than organizational average vaccine error rate. Site B was chosen to address its error rate, which was the highest in the organization. Nurses at both sites helped develop new workflows prior to spread to the rest of the organization.
Significant Findings/Outcomes: The vaccine error rates at both sites during project implementation was zero, but error rates were trending downward prior to BCMA initiation. Scan rates remained above 90% in site A, but were less consistent in site B. Despite problems with audit completion in site B, workflow compliance rates were above 90% in both sites. Nurses stated they prefer BCMA over the previous medication administration process.
Implications for Nursing: This project underscores the importance of engaging nurses in the design and execution of technological changes, fostering a culture of safety, and promoting the integration of evidence-based practices in ambulatory care settings.
Recommended Citation
Schwarz, Elizabeth R., "Implementation of Barcode Medication Administration to Reduce Vaccine Errors" (2024). Doctor of Nursing Practice (DNP) Scholarly Project. 11.
https://fuse.franklin.edu/dnp-project/11
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