"Nurses Don't Hate Change" -- survey of nurses in a neonatal intensive care unit regarding the implementation, use and effectiveness of a bar code medication administration system.

A bar code medication administration (BCMA) system reduced preventable adverse drug events (ADEs) by 47% in our neonatal intensive care unit (NICU). However, it is often expected that providers will not welcome technological change. Two years after BCMA system implementation, we studied the perceptions of nurses in our NICU to better understand their opinions about patient safety, use, acceptance and occupational effects of the new technology. Forty-six nurses (median age < 30 years) completed a 30-item questionnaire. Most nurses reported comfort using the system within two weeks. The majority believed that the system had prevented a medication error or ADE, although they were aware that medication errors persisted and workarounds occurred. Most reported that medication administration required more time with the BCMA system, but they believed that the alerts, which most reported occurred with < or =25% scheduled administrations, were not excessive. Over half of the nurses felt that the new system improved job satisfaction and increased professionalism. Although overall stress levels were moderate, nurses reported greater stress resulting from computer breakdowns than from other situations. Nurses reported strong support from supervisors, physicians and hospital administrators. These nurses were adaptive to the new technology when they believed it increases patient safety, nursing professionalism and job satisfaction and when they were supported by colleagues.