Effect of bedside scanning in a closed-loop system on medication administration errors

Abstract

Int J Clin Pharm (2025) 47:484-583 553 123 Background: Bedside scanning (BSS) is a technology to reduce medication administration errors (MAEs). However, the evidence regarding the effectiveness of BSS is contradictory, especially if other technologies of a closed loop medication management system are already in use. Aim: This study assesses the impact of BSS on MAEs within a closed loop medication management system, where other technologies are already implemented. The primary endpoint is the difference in prevalence of MAEs due to implementation of BSS. Furthermore, the difference in prevalence of the different types of MAEs was assessed. Method: This before-and-after study was conducted in one surgical ward and one medical ward of a 981-bed general hospital in Belgium. Data was collected by direct observation of nursing staff administering medication. A medication administration error was defined as a deviation from the electronic prescription or generally applicable procedures. A logistic regression random effect model and a generalized estimating equation model were used to investigate the impact of BSS on medication administration errors. Results: A total of 2.531 medication administrations were observed. Among the observations where the patient was correct, a total of 178 (4,40%) MAEs occurred pre-implementation and 129 (3,19%) MAEs post-implementation. The logistic regression random effects model showed a statistically significant reduction (p-value 0,0035) of MAEs with a correlation with the experience of the nursing staff within the institution. A higher effectiveness of BSS was observed among less years of experience. BSS tends to increase medication administration errors from 20 years of experience, however this was not statistically significant. The generalized estimating equation model showed a non-statistically significant reduction of MAEs. There was a reduction in absolute numbers of all types of medication administration errors, except omission. Conclusion: Implementation of BSS reduces the rate of medication administration errors, even with other closed loop system technologies in use. This study found a correlation between the effectiveness of BSS and years of experience of the nursing staff, emphasizing the critical role of the end-users of this technology. Further research is needed identifying factors affecting the effectiveness of BSS.