Improving Administration and Documentation of Enteral Nutrition Support Therapy in a Veteran Affairs Health Care System: Use of Medication Administration Record and Bar Code Scanning Technology

Mary M. Chew, Salvador Rivas, Michael Chesser, Noel Landas, Stephanie Schaefer, Amy Enright, Jamie Olsen, Katie Meacci, Victor Luevano, Doristeen Harraway, Sandra W. Citty

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives The goal of this project was to evaluate and improve the ordering, administration, documentation, and monitoring of enteral nutrition therapies within the inpatient setting in a Veteran's Health Administration system. Methods An interdisciplinary team of clinicians reviewed the literature for best practices and revised the process for enteral nutrition support for hospitalized veterans. Interventions included training staff, revising workflows to include scanning patients and products, including enteral nutrition orders within the medication administration record (MAR), and using the existing bar code medication administration system for administration, documentation, and monitoring. Baseline and postprocess improvement outcomes over a year period were collected and analyzed for quality improvement opportunities. Results Before process change, only 60% (33/55) of reviewed enteral nutrition orders were documented and 40% (22/55) were not documented in the intake flowsheet of the electronic health record. In the year after adding enteral nutrition therapies to the MAR and using bar code scanning, a total of 3807 enteral nutrition products were evaluated. One hundred percent of patients were bar code scanned, 3106/3807 (82%) products were documented as given, 447/3807 (12%) were documented as held (with comments), 12/3807 (<1%) were documented as missing/unavailable, and 242/3807 (6%) were documented as refused. Conclusions Inclusion of enteral nutrition order sets on the MAR and using bar code scanning technology resulted in sustained improvements in safety, administration, and documentation of enteral therapies for hospitalized veterans.

Original languageEnglish (US)
Pages (from-to)23-28
Number of pages6
JournalJournal of Patient Safety
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2023
Externally publishedYes

Keywords

  • bar code scanning
  • electronic health record
  • enteral nutrition
  • malnutrition
  • medication administration record
  • nutrition support
  • nutrition therapy

ASJC Scopus subject areas

  • Leadership and Management
  • Public Health, Environmental and Occupational Health

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