Making Medication Supply Safer
Barcode checking system
Components
1. Communication system between distant authorising medic/triage system and supply station – code authorising supply and defining drug/dose is added safety measure.
2. Pre-prepared/templated unique-barcoded labels for patient instructions.
3. Visible manufacturers barcode required on patient pack.
4. Unique Barcode is pasted back into patients notes, as record of supply.
A slide show outlining the system is
here - as html, or
here as pdf (with better quality pictures)
The current version of the sofware is
here
(run with python) or here [soon] (executable for windows - but may
still require python (or some of the libraries) to be installed)
In the tests we used "
HMS medical system" – an “Out of Hours” primary
care record system. This was adapted by the software provider to
provide a unique patient code for entry into our software, and also to
provide a space to paste back the unique code from supply. Since this
was a simple cut and paste, both ways (our software does the copy
automatically so only a 'paste' is required), any appropriate software
could be fairly easily adapted, I imagine.
This HMS system is used for two steps.
1.
When a patient rings the service, an operator (usually medic, could be nurse) populates an HMS patient entry, including a code to identify patient and drug/dose ordered
2. When patient collects from supply station, the identity/drug/dose code is pasted as patient ID into the AVSoft system. Once supply is confirmed, a generated code is pasted back into the HMS system, providing an audit trail of supplied medicine. The code identifies the actual pack supplied.
The process does not rely on HMS, but for full functionality does need an electronic triage system, of some sort.
Why is the system needed?
For the specific use anticipated – ie provision of anti-virals to patients who have not been examined by a doctor,
-by staff who may have no healthcare skills or knowledge
-where there could be many patients turning up at a time
The following describes the difference from more normal process using a pharmacy…
Anti-Viral Collection Point (ACP) vs Pharmacy
Pharmacy
Trained staff
5000+ different items
Need to repackage
Need to produce and attach label
Expected to provide advice
ACP
Limited training
5 items
No repackaging
Labelling ready prepared
Advice only in the form of pre-prepared leaflets
Supporting software
Step through of process in ACP using the software
- 1. Enter patient details - id will be from HMS (or equivalent) system
Patient weight is not required unless patient is under one year old, for the drugs included in this version
- 2. “Zap” barcode on patient label, and barcode on medicine box. If all details match as expected, four green lights show.
- . In the next case, the patient’s age has been entered incorrectly (or the wrong dose for the patient has been chosen) so Red lights show
- In the last example, the dose entered does not match the barcodes so more red lights show.
4.
All data for each supply is stored, and the unique barcode on the label is pasted back into the HMS (or other triage) system, providing a complete audit trail.
Many features left to include -
Network store for data
Ability to enter new drugs/barcodes (currently hard-coded)
Menu, help and documentation
Adaptation for other circumstances (vaccines, clinics etc), where trained staff may be hard to provide – emergencies, (eg Hiaiti), the Outback, etc.
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Last update 11 February 2010
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