Factors influencing bar-code verification by nurses during medication administration in a Dutch hospital

Am J Health Syst Pharm. 2008 Apr 1;65(7):644-8. doi: 10.2146/ajhp070368.


Purpose: Factors influencing the bar-code verification by nurses during medication administration in a Dutch hospital were studied.

Summary: The use of bar-code verification during medication administration in five medical departments was recorded daily for three weeks. These data were collected via electronic medication administration records. The frequency of bar-code verification was calculated as a percentage of all administrations, corrected for the availability of bar-coded packages. Nurses were asked why bar-code verification was not always used. A total of 23,492 medication administrations were recorded, 15,162 (64.5%) of which required bar-code verification. Bar-code verification was significantly influenced by the medical department, deviation between prescribed and administered times, administration route of the drug, number of nurses available in each department, and age of the nurse. The five most cited reasons for not verifying bar codes were difficulties in scanning bar codes on the medication labels, lack of awareness of bar codes on medication labels, delays in responses from the computerized system, shortage of time, and administration of medication before prescription.

Conclusion: Nurses verified the bar codes of only about half of medications administered to patients. Various factors influenced the frequency of bar-code verification by nurses except the number of medications administered. More education regarding medication safety is warranted to increase compliance to a bar-code-enabled point-of-care system.

MeSH terms

  • Adult
  • Age Factors
  • Attitude of Health Personnel
  • Attitude to Computers
  • Diffusion of Innovation*
  • Drug Labeling
  • Electronic Data Processing*
  • Guideline Adherence*
  • Hospitals, University
  • Humans
  • Medication Errors / prevention & control
  • Medication Systems, Hospital / organization & administration*
  • Middle Aged
  • Netherlands
  • Nursing Staff, Hospital / supply & distribution*
  • Organizational Case Studies
  • Patient Identification Systems
  • Point-of-Care Systems
  • Safety Management / methods
  • Time Factors
  • Total Quality Management / methods*