The introduction of Barcoded Medicine Administration (BCMA) is based on the assumption that when human action is eliminated as much as possible, drug distribution becomes safer. Marcel Boonen investigated the implications of this assumption. Below the summery of his dissertation.
BCMA starts from the assumption that nurses make mistakes and that applying technology solves this problem. You provide nurses with a scanning device so they no longer have to look closely at what they are doing, because the medication, for example paracetamol, is changed into a barcode that is checked by the computer. The dominant instruction is, follow the computer, scan medication, and trust on the explicit technology because that improves safety. But on the other hand, nurses are instructed not to totally trust the same technology and to keep looking out for flaws in the system, which is an appeal to their practical knowledge. Technology changes roles, identities and mutual expectations in a subtle though far-reaching manner. Some pivotal concepts such as technology, temporality, knowledge, point of view, and standpoint came to the surface as an qualitative empirical research was done by shadowing nurses on the ward. Zooming in and zooming out (a concept of Davide Nicolini) brought the necessary insight of different point of views (resulting in three theoretical lenses). P.P. Verbeek’s lens of technology and the lens of Institutional theory (Campbell, Rankin) showed the institutional and textual ruling of nurses practices by this medication technology. Practice theorists Davide Nicolini and Robert Schmidt provided a definition of practice. The third lens (knowledge) confirms the constant presence of different forms of knowledge in the practice situation where nurses work with technology. Our research is a qualitative empirical and conceptual study into the use of a drug safety system by nurses in an orthopaedic ward of a general hospital.
The manuscript opens with a biographical journey which brings us to the problem statement, followed by a chapter explaining the relevant literature that is used. Then, the chapter explaining the research method and strategy in this research is followed by four chapters, consisting of the articles that are published by or submitted to different journals. The final chapter is a reflection on this research and presents the findings and conclusions of this research.
You can read the full text of the dissertation here