BCMA in the NICU

As you know, I’m passionate about pediatric medication safety. I’ve blogged about BCMA and the unique needs for Pediatric Safety, so this recent article was especially interesting to me. The article published in Pharmacy Purchasing & Products, “Unique Safety Requirements for BCMA in the NICU,” describes the implementation of bar code technology at Brigham and Women’s (B&W), a 793-bed teaching affiliate hospital of Harvard Medical School.

B&W decided to initiate a critical evaluation of the hospital’s entire medication use process. Two of the major recommendations were to redesign the workflow in the Central Pharmacy to “use bar code technology in the preparation, check, and distribution of medications” and “implement BCMA at the patient bedside.” Initially B&W began the complex process of implementing these technologies throughout the inpatient units, and later in the NICU and newborn nurseries.

Putting BCMA into practice in newborn care areas presents unique challenges compared with other hospital departments. Because NICUs are high-risk environments that care for extremely vulnerable patients, special emphasis was placed on maintaining and improving neonatal patient safety from the initial discussions throughout the length of the project.

The NICU needed to have the same safe, closed-loop medication process established in other patient care areas. Additional goals were improved documentation through the elimination of transcription, assistance in prioritization of medication orders, increased accessibility to clinical decision support information, and improved communication among CPOE, pharmacy, and newborn eMAR.

To optimize efficiency, the newborn BCMA executive and business owner committees decided to combine the separate adult and NICU systems and retire the current NICU PHIS. The two had shared the same preparation and distribution programs within pharmacy operations, but were interfaced to separate CPOE systems. Plans were made to redesign the adult PHIS to accept newborn CPOE orders and incorporate program designs that provided optimized safety considerations for newborn patients.

As I’ve mentioned before, it’s important the healthcare industry understands that “pediatric patients are not just small adults.” Pediatric patients require special focus and need pharmacists that are trained in the specific area of pediatrics to ensure patients receive the right medication dosage. B&W’s

BCMA implementation in its NICU is admirable. More hospitals need to deploy technology that ensures fewer medication errors and higher quality care for pediatric patients. According to the article, “The newborn staff and leadership were anxious to complete the process successfully to ensure newborn patients receive the same safety benefits as the adult inpatients already protected by the technology.” I’m really looking forward to hearing more about B&W’s benefits to this high-risk population.

Does your central pharmacy use BCMA to track and manage medications? Do you use BCMA in your pediatric division?

This is the short link.