BARCODE SCANNING AND LONG-TERM CARE CENTERS IN THE ERA OF CORONAVIRUS
The Coronavirus has had a serious impact on every facet of our lives, but some areas have been hit more severely than others. One industry that has suffered profoundly is long-term care centers. There are many reasons that this segment of healthcare has been so hard hit. The Coronavirus is lethal for many older people, and they make up the highest percentage of residents in long-term care centers. Patients with weakened immune systems, or those with underlying health issues, are also at higher risk of dying from the Novel Corona Virus.
Across the healthcare spectrum, processes are being evaluated and redesigned to improve safety and prevent the spread of this and other viruses. If safer equipment is available, it’s being implemented as quickly as possible. Where new equipment is not an option, new procedures for use and sterilization are being implemented. Several of these procedures have existed for 10 to 20 years but are now garnering new focus as facilities examine best practices and apply them to this new era of healthcare.
The statistics regarding the Coronavirus are sad, but some steps can be taken to assist these facilities in minimizing the spread of disease while making workflows faster and less prone to error.
BARCODE MEDICATION ADMINISTRATION (BCMA)
Medication errors account for tens of thousands of deaths and medical complications each year, costing millions of dollars. (https://www.psychologytoday.com/us/blog/the-doctor-is-listening/201303/10-medical-errors-can-kill-you-in-the-hospital ) In particular, medication administration errors are the fourth most common medical mistake issue. Healthcare technology companies began looking for ways to reduce the likelihood of medication administration mistakes. In 1995, the first test of the BCMA system took place in a VA hospital in Topeka, Kansas. While not a perfect system, the BCMA was effective enough to continue finetuning, and in 2000, the system was implemented in hospitals across the nation.
For generations, if a patient required medication while staying in a long-term care facility, they needed a doctor to write out the prescription and indicate its use. The pharmacy received the written prescription, filled it, and waited for a nurse to retrieve it and give it to the patient. The nurse would verify the doctor’s order, and visually verify that the proper medication had been dispensed. The nurse would then administer the medication and indicate it on the patient’s chart.
This system was fraught with potential errors. Undoubtedly, it led to hundreds of thousands of deaths. The development of a system that could improve protections and reduce human error was a high priority. With the introduction of the BCMA, the opportunity to improve on this vulnerable area of healthcare was extremely promising. While not perfect, this barcode-based system offered the promise of reduced human error, more efficient dispensing, and improved verification of both medications being administered and patient identification for receiving the medication.
Here’s how the BCMA helps protect patients. The National Drug Code (NDC) requires drug manufacturers to label medication packaging with barcodes. This standardized system is mandated across the United States, so the same code is used for the same medication from Rhode Island to California. (https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory) When a patient requires a medication, the physician writes a prescription, and the pharmacy scans the medication to fill the prescription. If the patient is hospitalized, their ID tag is scanned to verify the patient’s identity and cross-checked against the doctor’s prescription order, and one more time against the medication. By digitally confirming these key elements, a solid safety net is put in place as part of the medication administration process.
Nurses are busy, and during a pandemic or other crisis, they are pulled in a ridiculous number of directions at once: patients being brought in to the care center, doctors asking for updates or additional information, phone calls coming in, patients requiring medication or other attention, or other nurses needing assistance. It’s no wonder they become distracted or require additional help. When patients need specific medications at specific times, nurses want all the extra help they can get. Barcodes and scanners are part of ensuring the correct medication gets to the right person.
In long-term care facilities, this level of verification helps to protect the residents from potentially deadly errors. By using barcode scanning to authenticate medication orders and recipients, nurses are assured of medication management efficacy in their facilities. The convenience, speed, and accuracy of barcode scanning help ensure this safety net is reliable and easy to use. Patients receive the correct medication, in the correct form and dose, at the correct time, all cross-referenced thanks to the data collection capabilities of barcode scanning. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254134/#B24 )
Healthcare barcode scanners are most often required to be portable. Scanners need to be able to capture data on paper at a computer terminal, then move the patient’s bedside to scan the ID wristband, then to the IV fluids or blood bag, which might be located on the opposite side or at the head of the patient’s bed. This portability saves time, disruption for patients, and improves the efficiency of nursing workflows.
Unfortunately, portability can also be a bad thing. Germs or viruses located in one room can be picked up and transferred to another room on nurses’ hands or on anything they may touch before washing or sterilizing their hands. Even with proper hand washing protocols, if the scanner comes into contact with a microorganism, the “bug” can be transferred to the next person who uses the scanner. To guard against this cross-contamination, the barcode scanner should be cleaned after each use. This raises another potential problem: the cleaners and disinfectants used by modern health care facilities are harsh, chemical concoctions capable of destroying the plastics used by some barcode scanner manufacturers. Choosing antibacterial or antimicrobial plastic does not guarantee viruses and bacteria won’t be transferred from bedside to bedside as those plastics can’t kill the organisms. For example, one study found that of items knocked or dropped to the floor in a hospital, 57 percent transferred pathogens to the hand of whoever picked it up. (https://www.verywellhealth.com/can-you-get-sick-from-germs-on-hospital-floors-4126539) Naturally, disinfecting that item and washing hands with sanitizing soap would eliminate the concern, but repeated cleaning can destroy an ordinary scanner.
Plastics that are “disinfectant ready” offer a safer solution. These plastics can withstand the most powerful cleaning and disinfecting products used in medical facilities around the US and the world. The chemical composition of these plastics ensures that the plastic housing of the scanner will not crack, discolor, or degrade in any way. (https://www.codecorp.com/storage/720/d007930-cr1500-cr2600-cr2700-cr7000-codeshield-data-sheet.pdf) Because of the fragile health of many long-term care patients, extra precaution such as stringent cleaning protocols are necessary for patient protection.
ELECTRONIC HEALTH RECORDS (EHR)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. Healthcare providers have had to develop new methods to protect the highly sensitive information they are charged with keeping. HIPAA regulations require that those charged with receiving patient information and storing it do so with the highest measure of safety and security. (https://www.hhs.gov/hipaa/index.html) HIPAA violations can be extremely costly to an individual or organization found out of compliance with the law. Fines can run in the thousands to hundreds of thousands of dollars for breaches in security. Individuals and organizations both take great care in protecting patients’ personal information.
To protect patient information and eliminating mistakes, many physicians and hospitals have begun using Electronic Health Records, or EHRs to record and maintain patient data. EHRs offer many advantages over traditional record keeping. First, they are up-to-date because information is entered immediately upon receiving it. Second, it’s a more accurate system. There are no paper forms that can be filled out incorrectly or incompletely. And there are no mistyped mistakes or misinformation due to unclear handwriting. Third, the file is stored securely on a server instead of a paper file that requires additional space. The file is easy to locate when needed, whereas paper files can be misplaced or misfiled. Fourth, EHRs require far less time and management than paper files, giving healthcare providers more time to spend with patients and helping the healthcare facility to operate more smoothly. Fifth, EHRs provide more security than paper files because only authorized healthcare personnel can see the information. Paper files can be left out accidentally on counters where unauthorized people may have access to them. (https://www.healthit.gov/faq/what-are-advantages-electronic-health-records)
For EHRs to accomplish so much, barcode scanning must be part of the process. For example, a patient’s ID may be scanned to verify their identity. Their insurance card may be scanned to ensure their coverage is in effect and to check if copayments may apply. For patients in a long-term care facility, an ID wristband may be issued that, when scanned, connects a nurse or doctor to that person’s EHR. If saline or blood is required for the patient, the blood bag or saline bag would be scanned, and that information would be entered in the EHR. The same is true for any medications the patient is given. The patient’s record is immediately updated with the most current and accurate information, and a record of treatment is available almost immediately to the doctors and nurses treating that patient.
In the early days of the COVID-19 outbreak, it became clear that barcode scanning could play a vital role in improving healthcare safety and accuracy. This proven technology has already demonstrated its value in the healthcare arena, but Code has gone further to provide scanning solutions that meet today’s healthcare environment requirements. Lightweight, easily portable, and made from Code’s proprietary CodeShield plastic, our line of medical barcode scanners is designed to handle the rigors of this challenging time.
The protocols for cleaning and sterilization of medical equipment have become more stringent than at any other time in history. The need for repeated cleaning and sterilizing of even the smallest piece of equipment has become a routine. Antimicrobial plastics are only capable of a minimal level of safety. While they resist the growth of bacteria on their surface, they can’t withstand the harsh, chemical compounds used by hospitals and clinics to clean and disinfect equipment. CodeShield plastics are uniquely designed to support the function of our barcode scanners and the health and safety of medical staff.
CodeShield plastics are “disinfectant-ready.” They can handle multiple cleanings in a day by hospital-grade disinfectants and cleansers over the course of years without any degradation, yellowing, or cracking on the scanner housing. This makes our scanners a great investment both in terms of safety and the bottom line.
Code’s scientists have created the most powerful algorithms to power our barcode scanning software. Our scanners are faster and more accurate than our competitors, with near-zero-miss accuracy when tested over thousands of scans. But speed and accuracy aren’t the only attributes worth examining.
The strength of our software allows our scanners to perform in ways that others can’t. In dim lighting, our scanners can read barcodes clearly. On curved surfaces such as wristbands or medication bottles, our scanners accurately collect the data. Our dual-field optics ensure the right data is read and collected on shiny or reflective surfaces or those with multiple barcodes such as blood bags or saline bags. And if a barcode is damaged or faded, our powerful algorithms decipher the data to be certain your staff has the information they need exactly when they need it.
Chaotic times call for innovative options. For more than 20 years, Code has been pioneering solutions that benefit the healthcare arena. We hold more than 100 patents for barcode scanning hardware and software that provide healthcare, and specifically long-term care facilities, with options for improving care and safety for patients and staff. Now is the time to do all you can for your facility, and Code is here to help. Contact us today to schedule your free demo.