Thibodaux Regional Medical Center
Center Enforces Bedside Medication Verification with Wristband Solution
Durable, Flexible Bands Prevent Workarounds and Contribute to High Scan Rates
In Thibodaux, La., Thibodaux Regional Medical Center, a 185-bed acute care facility, provides inpatient and outpatient care for the people of Lafourche and seven surrounding parishes. For the third consecutive year, J.D. Power and Associates recognized the center for service excellence under the Distinguished Hospital Program, acknowledging Thibodaux Regional's strong commitment to provide "An Outstanding Patient Experience" for inpatient and outpatient services.
To achieve and maintain its award-winning reputation, Thibodaux has progressed on several key initiatives in recent years. The medical center has increasingly moved toward a more paperless environment and brought in bedside medication verification (BMV).
With those strides, the hospital knew it needed to upgrade its approach to patient wristbands as well. Paper labels created paper waste, and didn't hold up well in the hospital environment.
"With each admission we were printing labels and slapping a sticker on a plain wristband," said Maria Clause, R.N., clinical analyst. "The paper labels would get wet and wear off quickly. We needed a reliable way to produce patient wristbands that scanned 100 percent of the time and didn't degrade."
Moreover, Thibodaux sought a solution that would help prevent nurse workarounds in BMV.
Soon after moving to bedside medication verification, Clause first heard about the Zebra® HC100™ Patient I.D. Solution at an industry conference. The HC100 combines a direct thermal printer with easy-to-load cartridges containing Zebra's durable Z-Band® wristbands. Hospital staff just pop cartridges into the printer to produce wristbands with barcodes and text that stay readable well after paper would degrade.
To test durability, the medical center first tried the bands on nurses, who wore them for a couple of weeks without noticing any degrading. With that success, the hospital brought printers into admissions and the emergency room.
As part of the decision, Thibodaux compared the costs of printing paper labels and the HC100 printers and found them comparable, especially given the rate at which staff had to reprint their paper labels.
Before moving to Zebra printers, labels included a single 1-D barcode, requiring hospital staff to manipulate patient wrists to scan them. Now, with the ability to easily configure exactly what goes on patient I.D. bands, Thibodaux prints smaller 2-D barcodes around the entire perimeter of each wristband for easier scanning without having to move the patient's wrist. They can also easily increase or decrease font sizes, or adjust printed information, such as the name, account number and date of birth that are used for positive patient identification.
In the nursery, the hospital uses infant Zebra Z-Band QuickClip™ wristbands in a soft nylon material for babies' sensitive skin.
Additionally, the hospital can flexibly add important care information on each band, such as medication allergies. To assist with that, Thibodaux also uses colored clips so caregivers have a visual reminder regarding specific patient care needs like allergies, Fall Risk, and Limb Alerts.
Mindful that nurses—ever efficient—sometimes find workarounds to processes, the medical center put a plan in place to ensure that nurses take all steps required for BMV. In particular, they wanted to prevent nurses from scanning barcodes from patient folders instead of patient wristbands—as is required for BMV.
Well before the hospital implemented BMV, Thibodaux conducted extensive research to understand potential workarounds in the industry. In response, Thibodaux flexibly used the Zebra solution to add a special "check" digit to the 2-D barcodes on patient wristbands. When nurses administer medication, they are only able to scan the wristband for patient identification. barcodes from chart forms will not scan, ensuring they are unable to circumvent the process.
"Before we went live, we knew about potential workarounds and put a plan in place—a checkpoint between the nurse and patient that protects patient safety," said Danna Caillouet, physician analyst, R.N. "That was a huge win for us. We're a step ahead of everyone else at conferences because we did so much homework prior to our implementation."
Thibodaux has seen a number of benefits with the HC100 bands. First, they create bands on-demand much more quickly than before. Wristbands come out of the printer ready to go, instead of staff having to pull off and affix sticky labels to a band.
Where before the medical center replaced worn bands frequently, the HC100 bands hold up to moisture and use. "The only time we have to replace a Zebra band is when a procedure requires that we cut off a band. They last for weeks and weeks," Clause said.
Durability and a greater number of barcodes on bands contribute to near-perfect patient scan rates. "The bands are so durable and easy to scan, we've had no failures in scanning," Clause said.