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Let’s stick to science, please – BCMA and grocery store rebuttal

02/19/2010

I really like reading the PointOfCareForum.com, Mark Neuenschwander’s musing.  I enjoy reading John Grisham as well, but would not base the practice of pharmacy on either.  Mr. Neuenshwander’s latest in a long line of non-disclosure of conflict musings on BCMA is entertaining.   While admitting it is trite to compare grocery stores to medication administration he writes an entire article about it.  When it comes to advocating practice, I think it is time to stick to science and leave the emotion, conjecture, and trite analogies to the Pulpit.

Here are some ‘science based’ comments on the points made in the muse.

“Lesson One: Everything does not have to be bar coded to get value from implementing BPOC for medication administrations.”
– This is an excellent point.  It would be extremely interesting to see outcome studies of limited BCMA on IV medications.   I have always wondered the ROI and real outcome, or lack there of, to bar code everything to insure that a patient’s lisinopril is given on time.

“Lesson Two: Even as bar-code limitations have been resolved in the grocery industry, they will continue to be resolved with BPOC applications in hospitals.”
– Let’s hope so.  The current 1st and 2nd generation of products are lacking.

“Lesson Three: Some items call for interim measures.”
–  I think this means that you should consider evidenced based practice interventions such as using the CalNOC principles of medication administration, instead of BCMA.
[Empowering Frontline Nurses: A Structured Intervention Enables Nurses to Improve Medication Administration Accuracy. Journal on Quality and Patient Safety. Volume 35 | Issue 12 | December 2009]

“Lesson Four: Workarounds are not an argument against bar coding at points of care any more than an erring priest is an argument against bar coding at points of sale.”
– Huh?  Of course it is.  If there is a high rate of overrides, which studies have shown, there is something seriously wrong with the process.

Let me state I believe that BCMA is an important patient safety intervention.  It is just that the science of its value is completely lacking.

Oh, I have no conflict of interest on this topic.

One more thing, I welcome and encourage alternative points of view; apparently unlike Mr. Nosh.

John Poikonen

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