Thoughts on creating a BCMA cross reference file

zebra_barcode2Our facility is gearing up to implement bar code medication administration (BCMA) in February 2010. Part of getting ready is making sure that all the medications dispensed from the pharmacy are bar code ready. If the medication isn’t bar coded or won’t scan, then it won’t do the nurse much good at the bedside. We’re in pretty good shape secondary to our carousel install in February of 2008. Everything that gets stored in the carousel is already bar coded. I had hoped that the file stored in our AutoPharm, i.e. carousel, cross reference file could simply be dropped into our Siemens Pharmacy cross reference file, but that would have been too easy. Siemens refused to play nicely with the data.

Anyway, I’ve spent the better part of the last two weeks walking the shelves and adding all our medication bar codes to the pharmacy system. Some things I’ve noticed include:

– Manufacturer’s bar coding practices are not consistent. Some use linear bar codes, while others use 2D or stacked bar codes. We need a standard.

– Linear bar codes appear to be tied to the NDC number, while 2D and stacked bar codes appear to contain “extra” information.

– Don’t scan the packaging or overwrapping for a medication. Scan the product directly if at all possible.

– IV bags, i.e. piggybacks, large volume parenterals, etc, that use white printing for their bar codes are difficult to scan. I have a request for the manufacturers that do this; stop it. I look like I’m performing a voodoo ritual every time I try to scan one of these bags. I guarantee you the nurses won’t like it.

– Every item I’ve added to the cross reference file will have to be verified by someone else. The “human factor’ guarantees that something will be attached to the wrong drug. It happened with the carousel install, and it will happen with BCMA.

– Speaking of the human factor, I found some mistakes in the pharmacy formulary while walking the shelves to create the cross reference file. Maybe we should check every item on the shelf at some predetermined interval, i.e. quarterly, yearly.

– This process is very time consuming. It would be nice to see wholesalers catalog the product bar codes as they come in and supply them in a downloadable format to the customer.

– Completely unrelated, but sevoflurane now comes in a plastic bottle. I’m not sure when it changed, but I remember when it came in a glass bottle. I always wondered what would happen if we dropped one and broke it in the pharmacy. I did drop and break a bottle of albumin once. It was like trying to clean up egg whites.

4 thoughts on “Thoughts on creating a BCMA cross reference file”

  1. Don’t you have a handheld collection device that will allow you to scan these, then upload the data later? You know, and automated upload, something that can parse the various bits based on the barcode type and do the right thing on the backend system?

    Sounds like you don’t, and that’s a crying shame. You just wasted a LOT of time doing it the way you had to do it, right?

  2. I did just waste a lot of time. It’s actually time that could have been spent doing a ton of other work. The problem resides in attaching the barcode information to the drug. You’ll have to give me some more information on the whole parsing thing because I don’t completely understand what you mean. If I scan a barcode and the system doesn’t recognize it, I have to physically link it to the correct drug.

  3. I can’t find an email address on this blog but I really like the zebra bar code graphic and I would like for permission to use it on my Midyear Student Poster. Thank you.

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