Abstract
OBJECTIVES: Barcode technologies are commonly used in hospital settings to improve medication safety. However, the implementation of these systems poses several challenges. This narrative review aims to synthesize qualitative studies exploring the facilitators and barriers associated with using barcode technologies in clinical environments. METHODS: This review is grounded in the theory of systems-based risk management. A comprehensive literature search was conducted in November 2022 across 3 databases: CINAHL; MEDLINE (Ovid); and Scopus. Two independent reviewers utilized a predetermined SPIDER (Sample; Phenomenon of Interest; Design; Evaluation; Research type) tool for article selection by using Covidence software. The qualitative data from the selected studies were systematically summarized. RESULTS: The search found 197 articles, of which 11 studies from 6 countries met the inclusion criteria. All included studies identified barriers, while 7 studies also highlighted facilitators. Seven common themes emerged as facilitators and barriers: efficacy; implementation; leadership; medication safety; process; technology; and user experience. Three themes-materials; system design; and work environment-were exclusively associated with barriers. Workarounds, such as bypassing barcoding, omitting process steps, and unauthorized process steps, were reported in 8 studies as responses to the barriers. CONCLUSIONS: This review underscores the complexity of implementing and maintaining high-leverage, technology-based systemic defenses in clinical practice. The findings provide a foundation for the improvement of the safety and usability of barcode technologies in hospital settings. Future research should focus on developing and testing interventions that address the identified barriers and enhance the facilitators to optimize the use of barcode systems.