MEDICATION SAFETY

Drugs belly up to bar codes

Prescription drug packaging may soon feature bar codes to help reduce the risk of medication errors, according to a proposed Food and Drug Administration (FDA) regulation. Some health care officials estimate that a bar code system could reduce drug errors by 50%. Indications from veterans' hospitals, which currently use their own bar code system for drugs, show significant drug error reductions.

With bar codes, a nurse would scan a patient's hospital wristband to find out which medications are needed and when. Then, the nurse would scan the intended drug. The scanner would sound an alarm if the drug is incorrect, the dose is wrong, or, for example, if it's a pill when the prescriber ordered a liquid. With proper programming, the system can catch other errors, too, such as if a prescriber orders a drug to which a patient has an allergy or if a drug might react with another prescribed medication.

The bar code regulation, expected to be final early in 2004, will apply to all prescription drug products, including vaccines and over-the-counter drugs packaged for hospital use. Although hospitals won't be required to use the bar code system, the FDA expects many facilities to implement it. The FDA estimates that bar codes will cost the pharmaceutical industry $50 million, and hospitals will spend more than $7 billion on scanners and computers.

INFECTION CONTROL

Fire safety officials douse use of alcohol hand rubs

Some hospitals have received citations from their local fire safety officials for installing dispensers containing alcohol-based hand rubs in hospital hallways. The Centers for Disease Control and Prevention has promoted the alcohol rubs as a quick, effective way of improving hand hygiene and reducing the risk of nosocomial infection. However, the National Fire Protection Association's safety codes for hospitals prohibit anything that limits patients' ability to exit their rooms. It's unclear as yet if fire marshals have concerns regarding dispensers of alcohol-based rubs in patient rooms.

Members from the Association for Professionals in Infection Control and Epidemiology (APIC) are working with hospital safety and engineering groups to resolve the issue. To submit your feedback, answer the "Fire Hazard Questionnaire" on APIC's Web site, http://www.apic.org. Interpretation and enforcement of fire codes is up to local fire safety officials, so hospital infection control professionals should contact them regarding placement and storage of these products.