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  1. Poon, Eric G. MD, MPH
  2. Keohane, Carol A. BSN, RN
  3. Bane, Ann MSN, RN
  4. Featherstone, Erica BS
  5. Hays, Brandon S. BA
  6. Dervan, Andrew BS
  7. Woolf, Seth BS
  8. Hayes, Judith MSN, RN
  9. Newmark, Lisa P. BS
  10. Gandhi, Tejal K. MD, MPH


Background: Many hospitals use barcode medication administration (BCMA) technology to improve inpatient medication safety. However, implementation of this technology requires significant changes in workflow for nurses, potentially interfering with the delivery of care to patients.


Objective: The aim of this study was to evaluate the impact of BCMA on nursing workflow.


Design: Time-motion study during direct observations before and after BCMA deployment was used.


Setting: The study was conducted at medical, surgical, medical-surgical, and intensive care units in a 735-bed tertiary care hospital.


Intervention: An internally developed BCMA solution that supports communication between the pharmacy and nursing, organizes workflow for nurses, verifies by barcode scanning every dose of medication and patient identification before medication administration, and documents medication administrations electronically was used.


Outcome Measures: The primary outcome was the proportion of time that nurses spent on medication-administration-related activities. Secondary outcomes included the proportion of time spent providing direct patient care and engaging in inefficient activities.


Results: We conducted a total of 232 two-hour observation sessions evenly split between pre-BCMA and post-BCMA units. The proportion of time nurses spent on medication administration activities remained unchanged (pre-BCMA: 26.9%, post-BCMA: 24.9%; P = .16). The proportion of time spent providing direct patient care increased (pre-BCMA: 26.1%, post-BCMA: 29.9%; P = .03). Time spent on inefficient activities fell from 10.8% to 7.3% (P < .0001).


Conclusion: A well-designed BCMA system did not increase the amount of time that nurses spent on medication administration activities. Barcode medication administration technology likely streamlined activities for nurses, allowing them more time for other professional activities. Our results should help to allay concerns regarding the impact of BCMA on nursing workflow.