Week 5 - barcoding and patient safety

Question 1

what is GS1

Answer 1

GS1 is a global non-profit automatic identification and Data Capture (AIDC) standards organization that manages many international data standards

Question 2

where are GS1 standards employed

Answer 2

employed across a number of businesses ranging from grocery and clothing retailers, agricultural equipment and HC products and processes

Question 3

GTIN - what does it abbreviate

Answer 3

global trade mark item number

Question 4

Types of barcodes

Answer 4

UPC A GS1 (GTIN 12)

GS1 DataBar (GTIN 14)

GS1 DataBar expanded

GS1 DataBar composite

GS1 datamatrix

GS1 QR Codes

Question 5

What bar codes are strictly 1D

Answer 5

UPC A GS1 (GTIN 12)

GS1 DataBar (GTIN 14)

GS1 DataBar expanded

Question 6

Mixed 1D and 2D databar

Answer 6

GS1 DataBar Composite

Question 7

2D compact databar

Answer 7

GS1 Data Matrix

Question 8

what databar is not yet approved for use in product automated ID

Answer 8

GS1 QR codes

Question 9

what does Bar coding bring efficiency and transparency to

Answer 9

retailers

manufacturers

suppliers

consumers

Question 10

what parts of the medication use system are enhanced by bar coding

Answer 10

Dispensing and administration

Question 11

Why bring automation to healthcare

Answer 11

to reduce medical error

Question 12

where do errors occur the most in the medication use system (order)

Answer 12

Prescribing > Administering > transcribing > Dispensing

Question 13

Top 3 types of errors

Answer 13

1) wrong dose
2) wrong choice
3) wrong drug

Question 14

What are the two types of human errors

Answer 14

Slips and mistakes

Question 15

define slips

Answer 15

an action that is either forgotten or the action is performed using an incorrect product or on the wrong target

Question 16

These are examples of what:

choosing the wrong medication by not reading a label carefully, choosing a wrong patient, or omitting a scheduled dose.

Answer 16

slips

Question 17

define msitakes

Answer 17

an error in execution where a human is generally alert, but consciously chooses the wrong action in the incorrect manner

Question 18

these are examples of what:

calculation mistake, incorrectly setting a pump rate, selecting an incorrect medication, choosing incorrect information to apply to the clinical situation.

Answer 18

mistakes

Question 19

Goal of automation

Answer 19

reduce errors

Question 20

at what stages does automation seek to reduce errors

Answer 20

at the pints of prescribing tanscribring dispensing and administration that are related to SYSTEM issues, through the use of infromation technology and automation

Question 21

Role of automated support

Answer 21

routine medication process tasks can be best supported by carefully-planned automated support

• reduces potential for inadvertent human error
• maximizes opportunity for patient focused care

Question 22

incorporating automation and bar code scanning at inventory, medication repackaging, dispensing, compounding, and drug distribution effectively: (4)

Answer 22

reduce reliance on memory

improves communication

improves access to information

improves productivity and team work

Question 23

shared belief on automation

Answer 23

importance of medication automation for improving medication safety

Question 24

Medication product chain

Answer 24

pharmaceutical manufacterer

warehouse and shipping

HC contracting and purchasing

institutional or retail inventory storage

pharmacy compounding

pharmacy dispensing

pateitn care area storage of bulk or individual therapies

drug/dose selection

dose administration to patient

Question 25

pharmacy has to ensure safe efficient and effective delivery of medication therapy - what stages: 6

Answer 25

Medication re-packaging / pre-packaging to unit of use / unit dose packages from the original manufacturer’s bulk product sterile and nonsterile medication compounding medication dispensing medication distribution from the pharmacy to designated patient care areas restocking of a medication storage area on the patient care unit medication dispensing of the Rx to a consumer

Question 26

Medication automation systems: (5)

Answer 26

automated pharmacy inventory management/ vertical carousel technology automated packagers Robotics automated medication cabinet smart infusion devices

Question 27

automated pharmacy inventory management/ vertical carousel technology (4 adv)

Answer 27

- better controlled and tracked, - improving space utilization, - inform where a product, - reduce walking and searching

Question 28

Automated packagers

Answer 28

repackage and label bulk supplies of medications into patient specific unit doses of medications

Question 29

robotics (4 uses)

Answer 29

pharmacy inventory repackaging fast and accurate medication dispensing returning drug stock to inventory for unused unit of use medications

Question 30

Automated medication cabinet | -7 benefits

Answer 30

increase authorized access to both medications and patient info improve medication security improve medication trunaround time increased productivity medication accuracy and safety improvement in patient care improvement in drug use management and inventory

Question 31

Smart infusion devices | - combined with bar coding

Answer 31

provide automated ID options for pump programming (including the GS1 datamatrix bar code) -significantly enhance safety features of these devices

Question 32

Smart infusion Devices | -bar code ID of user and patient

Answer 32

smart infusion device may reduce error potential to administer the wrong drug/ rate/patient and can also auto-ID the care provider as well as auto-ID the patient

Question 33

Canadian drivers for medication bar coding -who regulates DIN - DIN is unique to what - what is not included in DIN - Canada health infoway designated what as CAS - 2 others

Answer 33

In canada while the DIN is regulated by HC and designated to a pharmaceutical product: the DIN is uique to the API, str, unit of measure, dsg form, and manufacturer BUT DIN does not reflect package sizze Canada health infoway designated GS1 GTIN as Canadian Approved Standard (CAS) for uniquely ID'ing pharmaceuticals throughout ea stage of the medication use process Canadian Pharmaceutical Bar Coding Project (ISMP) Canada Vaccine Bar coding initiative (PHAC)

Question 34

Canadian vaccine Bar coding initiative (PHAC) - when work begin - what types of bar codes (primary package and secondary package and case level package)

Answer 34

see slide 28 for parts of bar code work began around 2007 80% vaccine prods as of 2018 have - 2D bar codes on primary packaging - 2D linear bar codes on secondary package - GS1-128 bar code on the case level package

Question 35

Why not bar code and automation everywhere (8)

Answer 35

infrastructure considerations workflow process considerations selection of bar code symbology hardware decisions employee ID badges/Patient ID badges ``` staff resistance -need health technology assessment (HTA) - evaluate: +evidence (efficacy +economics (cost effectiveness) + ethical issues (patient preference) ```