| Course | NUR-7120 Nursing Administration Resource Acquisition and Management |
|---|---|
| Module | Module 3 |
| Paper type | Administration paper: technological resources |
| Length | About 1,002 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | M.S. in Nursing, Nursing Administration |
| Updated | October 2026 |
Free sample paper for NUR 7120 Module 3
Seventy-Eight Percent Scanned: Why Nurses Work Around Bar-Code Medication Systems
Student Name
M.S. in Nursing, Nursing Administration, Thomas Edison State University
NUR-7120: Nursing Administration: Resource Acquisition and Management
Mentor Name
Month Day, Year
Seventy-Eight Percent Scanned: Why Nurses Work Around Bar-Code Medication Systems
The Problem
About a year ago, our hospital introduced bar-code scanning together with an electronic medication record across all inpatient units. With each dose, the nurse first scans the patient's identification band and then the drug, alerting them to wrong patients, wrong drugs, wrong doses and wrong times. The pharmacy's report showed that on our unit, 78 percent of doses were fully scanned, below the hospital target of 95 percent. Two near misses in the past quarter involved doses given without scanning.
Why It Matters
Poon et al. (2010) directly observed over 14,000 doses at a single academic hospital, contrasting the period before bar-code scanning and an electronic medication record arrived with the period after. Where the system was in place, mistakes other than mistimed doses dropped by roughly 41 percent, and the potential drug injuries those mistakes could cause dropped by roughly half. Timing errors also fell, and transcription errors were essentially eliminated. The benefits depended on the system actually being used as designed.
Workarounds
Koppel et al. (2008) observed nurses and analyzed hospital data at several sites and cataloged 15 kinds of workaround, such as scanning a duplicate identification band stuck to a medication cart, scanning medications after giving them, overriding alerts without reading them and scanning one package to document several. They traced these to 31 types of causes in five groups: problems with the technology, such as unreadable bar codes and malfunctioning scanners; problems with the task, such as time pressure; organizational causes, such as policies that conflict with the system; patient factors, such as patients in isolation or asleep; and environmental factors, such as poor wireless coverage. They argued that workarounds signal design and workflow problems and that blaming nurses misses the cause.
Why Nurses Adopt or Resist
Holden and Karsh (2010) examined how the technology acceptance model has been applied in health care studies. The model holds that two judgments drive a person's intention to adopt a tool: how useful it seems and how effortless it seems. Of the factors tested, the belief that a tool is useful predicted clinicians' plans to use it most reliably. The authors concluded that the model explains a good part of acceptance but should be extended to include the clinical setting, workflow and social influences, such as what respected colleagues do.
| Source | Key point | Application to the unit |
|---|---|---|
| Poon et al. (2010) | Scanning cut errors other than timing by about two fifths | Scanning is worth protecting |
| Koppel et al. (2008) | Workarounds have technical, task, organizational, patient and environmental causes | Find causes before retraining |
| Holden and Karsh (2010) | Usefulness and ease of use drive adoption | Make scanning easier and show its value |
Finding Our Causes
With the unit's practice council, I observed medication passes on day and night shifts for two weeks and asked nurses what got in the way. Using Koppel and colleagues' categories, we found technical causes, such as wristbands printed on a worn printer that scanners could not read and scanner batteries that died mid-shift; environmental causes, such as weak wireless coverage in the last two rooms on the hallway; and task causes, such as drugs from the pharmacy arriving without bar codes, especially split tablets. Nurses had begun taping spare wristbands to their carts to save time.
The Plan
We addressed each cause. Biomedical engineering replaced the wristband printer and added a second charging station so that every cart has a spare scanner. Information technology added a wireless access point at the end of the hall. Pharmacy agreed to label split tablets with bar codes before sending them. The practice council removed taped wristbands from carts and created a quick reference card for scanning patients in isolation. These changes target ease of use, which Holden and Karsh identify as a driver of acceptance.
Showing Usefulness
To address perceived usefulness, we shared at a staff meeting two examples from our own unit in which the scanner caught a wrong-patient dose, with details removed, and posted monthly scanning rates with the number of alerts that prevented an error.
Involving Nurses
Two night-shift nurses who were respected informal leaders joined the practice council as scanning champions, reflecting the social influences Holden and Karsh describe.
Measuring Results
We will track scanning compliance weekly by nurse, shift and cause of missed scans, and report it monthly. Our goal is 95 percent within three months.
Downtime and Backup
When the system or network fails, nurses must give medications safely without scanning. The practice council reviewed the hospital's downtime procedure, which uses a printed medication record and an independent double check by another nurse for high-alert medications, and added it to the annual skills day so that the backup is familiar rather than improvised.
Alert Fatigue
Nurses also described alerts that fired for harmless timing differences, such as a dose given 35 minutes early, which taught them to click past warnings. Pharmacy and informatics agreed to review the timing alert window and remove low-value alerts, so that the warnings that remain are taken seriously.
Training New Staff
New hires and float nurses learn the system during orientation, but often on a quiet training unit. The practice council added a short scanning check-off on our own unit, covering our equipment, the isolation room procedure and where spare scanners are kept, so that new staff do not learn workarounds from the start.
Budget Implications
The new printer, scanners and wireless point cost about $11,000, far less than one serious medication error would cost.
Limits
Poon and colleagues studied one academic center. Scanning compliance does not measure whether nurses read alerts. The unit is invented.
Conclusion
Poon and colleagues showed that bar-code systems prevent medication errors when used, Koppel and colleagues showed that workarounds arise from fixable causes and Holden and Karsh showed that ease of use and perceived usefulness drive adoption. Repairing equipment, filling wireless gaps, labeling every dose, sharing near-miss stories and involving respected nurses address why scanning was skipped rather than who skipped it.
References
Holden, R. J., & Karsh, B.-T. (2010). The technology acceptance model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159-172. https://doi.org/10.1016/j.jbi.2009.07.002
Koppel, R., Wetterneck, T., Telles, J. L., & Karsh, B.-T. (2008). Workarounds to barcode medication administration systems: Their occurrences, causes, and threats to patient safety. Journal of the American Medical Informatics Association, 15(4), 408-423. https://doi.org/10.1197/jamia.M2616
Poon, E. G., Keohane, C. A., Yoon, C. S., Ditmore, M., Bane, A., Levtzion-Korach, O., Moniz, T., Rothschild, J. M., Kachalia, A. B., Hayes, J., Churchill, W. W., Lipsitz, S., Whittemore, A. D., Bates, D. W., & Gandhi, T. K. (2010). Effect of bar-code technology on the safety of medication administration. New England Journal of Medicine, 362(18), 1698-1707. https://doi.org/10.1056/NEJMsa0907115
NUR 7120 Module 3 instructions, in plain terms
Technological resources are named in TESU's catalog description of NUR-7120, and as the syllabus stays inside the course, this third paper is modeled as a technology evaluation. Choose a technology already in use, present data on how well it is being used and report evidence on its benefits when used as designed. Analyze the reasons for poor use with a published framework, based on observation and staff input, then match each cause to a fix. Explain how you will make the technology easier to use and show its value, involve staff and measure results. Address the cost of the changes. Some sections ask for a plan to select or purchase a new technology instead. Ask whether a cause-and-effect diagram should be included.
Inside the NUR 7120 Module 3 example
Scanning compliance on Monique Bell's telemetry unit is 78 percent a year after bar-code medication administration began, and two near misses involved unscanned doses. Poon and colleagues' safety study, Koppel and colleagues' workaround analysis and Holden and Karsh's technology acceptance review appear side by side in a table with their unit applications. Two weeks of observation with the practice council trace workarounds to worn wristband printers, dead scanner batteries, weak wireless signal and unlabeled split tablets. Each cause is matched to a fix, near-miss stories show usefulness, respected nurses become champions and compliance is tracked weekly. Budget implications, limits and a conclusion follow. Sections on downtime procedures and on reducing low-value alerts are included before the budget.
Reading the NUR 7120 Module 3 grading rubric
Technology papers earn credit when they present usage data, report the technology's benefits accurately and treat workarounds as evidence of design and workflow problems. Readers look for causes found by observing work and asking staff, sorted with a published framework, and for each cause matched to a specific fix. Addressing both ease of use and perceived usefulness, and involving respected staff, shows understanding of adoption. Measuring compliance by cause, setting a target and accounting for the cost of changes show administrative follow-through. Avoiding blame while maintaining safety standards shows leadership. Addressing alert fatigue and downtime shows a full view of how technology is used day to day.
NUR 7120 Module 3 help from the desk
Technology papers often blame staff for poor compliance and propose retraining. Observe the work, ask staff what gets in the way and sort the causes with a published framework. Match each cause to a fix, such as equipment, network coverage or pharmacy labeling. Make the technology easier to use and show staff that it prevents real errors. Track compliance by cause and set a target. Include the cost of the fixes. Tell us your module prompt and the technology you are evaluating, and a free first draft will be sent your way. Include what happens when the system is down and whether alerts need tuning.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 7120 Module 3 questions, answered
Where can I find a free NUR 7120 Module 3 sample paper?
The bar-code medication administration paper, from 78 percent scanning to a fix for each cause, is posted here.
Does bar-code medication administration reduce errors?
Yes; in Poon and colleagues' study, scanning units made far fewer non-timing mistakes, with potential drug harm cut by about half.
Why do nurses work around bar-code systems?
Koppel and colleagues traced workarounds to technical, task, organizational, patient and environmental causes.
What is the technology acceptance model?
A model that predicts technology uptake from how helpful and how simple people expect it to be.
How can managers improve scanning compliance?
By fixing equipment and workflow causes, showing staff the system's value and involving respected nurses.