Go backSearch Session number: 1124

Abstract title: Usability Test of Bar Code Medication Administration (BCMA)

Author(s):
ES Patterson - VA Midwest Patient Safety Center of Inquiry
M Rogers - VA Midwest Patient Safety Center of Inquiry
A Eisenlohr - VA Midwest Patient Safety Center of Inquiry
P Ebright - Indiana University
ML Render - VA Midwest Patient Safety Center of Inquiry

Objectives: Poor usability of medical devices contributes to adverse outcomes. Usability engineering techniques, including cognitive task analysis, heuristic evaluations, and usability testing, can increase patient safety by minimizing opportunities for and consequences from misinterpretations of software output and erroneous input by health care personnel. Usability testing of Bar Code Medication Administration (BCMA) illustrates the benefits of the methodology for medical systems in general and proactively identifies usability problems that could potentially contribute to medication adverse events. We performed a usability test of BCMA and asked: What tasks are difficult or inefficient for nurses to accomplish with BCMA that could be accomplished more quickly and easily with an easier-to-use design?

Methods: Participants were RNs with varying experience and BCMA familiarity. Each participant simulated passing medications to six patients on an acute care ward after listening to a shift change tape. The participants were interrupted 12 times during the medication pass to simulate actual work situations. Data included time to complete tasks, medication administration logs, think-aloud verbal protocols captured on videotape, and responses to a validated questionnaire. Each session was conducted by an expert in usability testing.

Results: The usability test participants included an experienced RN (pilot participant) who had never used BCMA, two RN nursing graduates who had never used BCMA, and two experienced RNs who use BCMA every day. The participants’ average response to “Overall, I am satisfied with how easy it is to use this system” was 4.6 (1-7 scale). Novice BCMA participants did not take more time than experienced BCMA participants (9.2 vs. 12.8 minutes per patient). Novice participants had more difficulty understanding that medications marked with a “G” had been given, locating PRN medications, documenting PRN effectiveness, and requesting a missing medication. All had difficulty detecting a missing Vancomycin order, documenting a refused medication, and detecting a patient allergy.

Conclusions: Usability testing identified areas for improvement of the BCMA interface that may reduce the likelihood for all BCMA users, and particularly for novice users, of using the system in a way that contributes to medication adverse events.

Impact statement: Redesign recommendations will be presented to the BCMA design team.