At the medical center bar code medication administration technology was implemented into the nursing workflow using the three steps of Jidoka:
1. Assigning work to humans and machines on the basis of their differing abilities
2. Adapting machines to the human workflow
3. Monitoring the human-machine interaction
Trained nurses observed a total of 16,149 medication doses for 3,617 patients in a three-year period.
The study found that the number of safe practice violations decreased from 54.8 violations/100 doses to 29 violations/100 doses. The number of medication errors decreased from 5.9 errors/100 doses at baseline to three errors/100 doses after implementation of the bar code medication administration technology. Also, the number of unsafe administration practices decreased.
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