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									American Nurses Association - The Critical Nature of Early Nursing Involvement for Intr... Page 1 of 13

             The Critical Nature of Early Nursing Involvement for Introducing
             New Technologies
                                            Heather N. Weckman, MS, CNL, RN-BC
                                           Sandra K. Janzen, MS, RN, NEA-BC, FAAN


                    This article emphasizes the crucial role of early nursing involvement whenever a new
                    technology, such as a Bar Code Medication Administration (BCMA) system, is introduced
                    in a patient care setting. The authors of this article describe how nurses participated on
                    interdisciplinary teams during the design, planning, implementation, and evaluation
                    phases of BCMA point-of-care technology at their facility. They illustrate the benefits of
                    early nursing involvement in all phases of introducing BCMA technology, and the
                    problems that can arise in the absence of this early nursing involvement, using real-life
                    examples of lessons learned during the initial implementation and further expansion of
                    the BCMA system at their facility.

             Citation: Weckman, H., Janzen, S., (May 31, 2009) "The Critical Nature of Early Nursing Involvement
             for Introducing New Technologies" OJIN: The Online Journal of Issues in Nursing, Vol. 14, No. 2,
             Manuscript 2. Available:

             Key words: Bar Code Medication Administration, BCMA, technology implementation, nursing
             involvement in technology implementation, patient safety, interdisciplinary team

             Technology specialists are experts in the field of technology; they understand the mechanics of a new
             technology. In the same way, nurses are experts in the field of nursing; they understand the dynamic
             flow of patient care and the frequent interactions needed between numerous healthcare providers
             while providing nursing care. It is important both for nurses to understand a new technology, and for
             technology engineers to understand how the equipment and software will need to interface with the
             facility’s existing systems. In this article we consider technology to include both the hardware
             (equipment) and the related software of a given technology,

             Involving nurses who work at the point of care in all phases of introducing a new technology facilitates
             a smooth transition to using the new technology and increases nurses’ buy-in of the system (Hunt,
             Sproat, & Kitzmiller, 2004). The Standish Group (1995) has noted that without user involvement the
             chance of failure increases dramatically. Kramer and Schmalenberg (2008) have observed that nurses
             will and do adopt new technologies if they have had the opportunity to provide input into the planning
             and implementation processes by conducting trials of various types of equipment in different clinical
             settings, and also the evaluation process by which they can confirm whether changes designed to
             improve the work environment have been effective. The authors of this article will describe efforts to
             promote early nurse involvement when introducing a new technology, specifically the Bar Code
             Medication Administration (BCMA) system. After describing the context in which they worked to
             introduce this technology and the BCMA system, they will share their early attempts to introduce a
             BCMA system and then describe how this implementation process was facilitated by active nurse
             involvement in the later planning phase, as well as in the implementation and evaluation phrases. 7/10/2009
American Nurses Association - The Critical Nature of Early Nursing Involvement for Intr... Page 2 of 13

             The Context for Introducing Bar Code Medication Administration Technology

             Our experience in introducing a BCMA system took place in the James A. Haley Veterans’ Hospital, a
             569-bed Magnet hospital. In 1998, the Department of Veterans Affairs embraced the Patient Safety
             Goal of reducing adverse events by 50% in five years. To support this goal, the Veterans Health
             Administration (VHA) began implementing the BCMA system nationwide. This technology was first
             introduced at our f
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