Evidence map›Paper›PMID 38902018›Full record

ArticleBMJ quality & safety2024

Raising the barcode: improving medication safety behaviours through a behavioural science-informed feedback intervention. A quality improvement project and difference-in-difference analysis.

Kate Grailey, Alix Brazier, Bryony Dean Franklin, Clare McCrudden, Roberto Fernandez Crespo, Helen Brown, James Bird, Amish Acharya, Alice Gregory, Ara Darzi and 1 more

Abstract read
In one paragraph

Article in BMJ quality & safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kate GraileyCentre for Health Policy, Imperial College London Institute of Global Health Innovation, London, UK k.grailey18@imperial.ac.uk.ORCID 0000-0002-4104-8444
Alix BrazierThe Behavioural Insights Team, London, UK.ORCID 0000-0003-3911-7161
Bryony Dean FranklinCentre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK.ORCID 0000-0002-2892-1245
Clare McCruddenHelix Centre, Imperial College London Institute of Global Health Innovation, London, UK.
Roberto Fernandez CrespoCentre for Health Policy, Imperial College London Institute of Global Health Innovation, London, UK.ORCID 0000-0002-2328-3782
Helen BrownThe Behavioural Insights Team, London, UK.
James BirdImperial College Healthcare NHS Trust, London, UK.
Amish AcharyaCentre for Health Policy, Imperial College London Institute of Global Health Innovation, London, UK.
Alice GregoryHelix Centre, Imperial College London Institute of Global Health Innovation, London, UK.
Ara DarziDepartment of Surgery and Cancer, Imperial College London, London, UK.
Sarah HufImperial College London Institute of Global Health Innovation, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Barcode medication administration (BCMA) technology can improve patient safety by using scanning technology to ensure the right drug and dose are given to the right patient. Implementation can be challenging, requiring adoption of different workflows by nursing staff. In one London National Health Service trust scanning rates were lower than desired at around 0-20% of doses per ward. Our objective was to encourage patient safety behaviours in the form of medication scanning through implementation of a feedback intervention. This was informed by behavioural science, codesigned with nurses and informed by known barriers to use. Five wards were selected to trial the intervention over an 18-week period beginning August 2021. The remaining 14 hospital wards acted as controls. Intervention wards had varying uptake of BCMA at baseline and represented a range of specialties. A bespoke feedback intervention comprising three behavioural science constructs (gamification, the messenger effect and framing) was delivered to each intervention ward each week. A linear difference-in-difference analysis was used to evaluate the impact of our intervention on scan rates, both for the overall 18-week period and at two weekly intervals within this timeframe. We identified a 23.1 percentage point increase in medication scan rates (from an average baseline of 15.0% to 38.1%) on the intervention wards compared with control (p<0.001) following implementation of the intervention. Feedback had most impact in the first 6 weeks, with an initial percentage point increase of 26.3 (p<0.001), which subsequently plateaued. Neither clinical specialty nor number of beds on each ward were significant factors in our models. Our study demonstrated that a feedback intervention, codesigned with end users and incorporating behavioural science constructs, can lead to a significant increase in the adoption of BCMA scanning.

Indexed as

Medication ErrorsPatient SafetyQuality ImprovementBehavioral SciencesElectronic Data ProcessingFeedbackHumansLondonMedication Systems, HospitalMedication safetyNursesQuality improvement

Identifiers

PMID38902018
PMCPMC11503117

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.