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Top1. Introduction
Medication errors in healthcare are one of the main causes of patient harm (Radley et al., 2013). The Institute of Medicine (IOM) estimates that medication errors happen at least daily in hospitals (Aspden et al., 2007). The cost of medication errors is high and leads to inefficient utilization of healthcare organization resources (Chan et al., 2008). Typical medication administration process involves physicians to write medication orders and nurses to carry out these orders by administering medications (Leape et al., 1991). This process carries the risk of many errors (Elixhauser and Owens, 2007). Medication administration has moved gradually to be electronic in line with the movement to digitalize healthcare processes. Digitizing medication administration involves introducing the Barcode Medication Administration (BCMA) System, which is considered to be a powerful tool to prevent errors and ensure more manageable support of patient safety (Radley et al., 2013). BCMA systems bring many technologies into the workflow of the medication administration process (Hook et al., 2008). However, this system may be difficult to implement due to various reasons (Klingner and Prasad, 2013). This difficulty comes from its direct effect on the patient safety (Poon et al., 2010).
A wide range of studies address the concept of patient safety in literature and there are factors that found to contribute to patient safety mentioned in literature reviewed in this study. Schein (2010) identified leadership as the first factor that affects patient safety in healthcare organizations directly. This finding was supported by another study done by Squires and his colleagues in 2010 that identified those leaders acknowledgement is essential to deal with high-risk healthcare environments, and seeks to align vision/mission, staff competency, and fiscal and human resources from the boardroom to the frontline (Squires et al., 2010).
Alahmadi (2010) identified teamwork, a spirit of collegiality, collaboration, and cooperation among healthcare professionals as key to patient safety and Greenfield et al (2011) added evidence base practice to this finding. Communication was identified as a key patient safety factor by large number of studies (Cima et al., 2011; Groves et al., 2011 & Russ et al., 2013). Joint Commission International accreditation (JCIA) has identified six main approaches to patient safety and structured them to be the international patient safety goals (Almidani et al., 2014). Medication safety is one of these safety goals (JCI, 2013). Research on medication errors, effects, and solutions, has been ongoing for three decades, and one of these solutions is using the BCMA system (Leape et al., 1991). BCMA is typically utilized in conjunction with an electronic medication administration record (eMAR) system (AHA, 2002). This system offers several levels of functionality by helping to enforce the rights of patient medication administration rights (i.e. right patient, right drug, etc.) that are likely to be more accurate than a manual medication administration (Hook et al., 2008).