When something goes wrong with a patient or a med

When the barcode scan fails and you give the med anyway

You checked the patient and the med by hand. If the override box just says 'scanner down', the chart says you skipped the check.

6 min read built on 0 cases updated 2026-10-10

Written by a med-surg RN, ten years, day shift. Why there is no name on it · How this guide is made

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The wristband won't read. Or the scanner keeps dropping off the network, or the drug came with no barcode at all. So you check the patient and the med by hand, give the dose, and the system asks why you overrode. What you type in that box and in your note is the only proof the check happened. There is no other record.

Key points

  • Write why the scan failed, and be specific: wristband barcode unreadable after 3 attempts. Don't write scanner issue.
  • Write how you identified the patient. Name the two identifiers and what you checked them against: wristband text, MAR, the patient saying them out loud.
  • Write how you matched the drug: label against MAR for drug, dose, route and time. If your unit wants a second-nurse check for this drug or this situation, put the second nurse's name in.
  • Write what you did about the cause. Band reprinted, IT ticket opened, pharmacy told about the label that won't read.
  • Never fake a scan. No spare wristband label on the cart. No scanning a sticker instead of the actual dose.

What to write

A good entry answers four questions every time: why the scan failed, how you ID'd the patient, how you matched the drug, and what you did about the cause.

Wristband won't read

How it often gets written How it could be written
Override: unable to scan ptOverride: pt wristband barcode unreadable (smudged), 3 attempts. Pt ID by name + DOB verbalized by pt, matched to wristband text and MAR. New band requested from registration 0915.
Band wouldn't scan, verified ptWristband scan failed x3. Pt stated full name and DOB, matched to printed band and MAR. Band replaced 0930, rescan successful for subsequent doses.

Scanner or network down

How it often gets written How it could be written
Scanner downOverride: handheld scanner not connecting to network, second device also failed. Pt ID: name + MRN on wristband checked against MAR. Drug: label checked against MAR for drug, dose, route, time. IT ticket #[NUMBER].
System issue, given per MARBCMA unavailable 1400-1445 (unit-wide). Meds given using manual verification against printed MAR per downtime procedure. Doses entered after system restored.

Drug won't scan or has no barcode

How it often gets written How it could be written
Med not scannableOverride: pharmacy label barcode on vancomycin bag does not read (scanned on 2 devices). Label checked against MAR: drug, dose 1250 mg, route IV, rate, pt name. Pharmacy notified, relabel requested.
No barcode, verifiedOverride: pt's own home med (approved per order), no hospital barcode. Pt ID: name + DOB. Bottle label matched to order: drug, strength, dose. Second RN [NAME] verified.

Off the unit (procedure, imaging, transport)

How it often gets written How it could be written
Given in IR, no scannerOndansetron 4 mg IV given 1105 in IR suite, no BCMA device available. Pt ID: name + DOB verbalized, matched to wristband and MAR before dose. Vial checked against order. Documented on return to unit 1150.
Late documentationLate entry for dose given 1105 in radiology. Entry made 1150 on return to unit. Verification at time of dose: see note.

Yes, the right column is longer. But it's mostly the same short phrases over and over. Once they're habit, an entry takes about twenty seconds.

Template

Override reason (short, fits the free-text field)

Scan failed: [WRISTBAND / DRUG LABEL / DEVICE / NETWORK] - [SPECIFIC PROBLEM], [NUMBER] attempts.
Pt ID: [IDENTIFIER 1] + [IDENTIFIER 2] matched to wristband and MAR.
Drug: label matched to MAR for drug, dose, route, time.
[SECOND RN: NAME, if required]. [ACTION TAKEN: band reprinted / IT ticket # / pharmacy notified].

Nursing note

[DATE] [TIME]. [DRUG] [DOSE] [ROUTE] administered without successful barcode scan.
Reason: [SPECIFIC CAUSE, e.g. wristband barcode unreadable after 3 attempts on 2 devices].
Patient identification: patient verbalized [IDENTIFIER 1] and [IDENTIFIER 2]; matched to printed wristband and MAR before administration.
Medication verification: [DRUG] label checked against active order on MAR for drug, dose, route, and scheduled time. [Independent double check by [NAME], RN, at [TIME] / No second check required for this medication].
Location: [UNIT / PROCEDURE ROOM / IMAGING]. [If late entry: dose given at [TIME], documented at [TIME] on return to unit.]
Follow-up: [band replaced at [TIME] / IT ticket [NUMBER] opened / pharmacy notified at [TIME] re unreadable label].
Patient response: [ASSESSMENT FINDINGS OR NO CHANGE].
[YOUR NAME], RN

Message to charge nurse, pharmacy or IT

[DATE] [TIME], [UNIT], room [ROOM].
Barcode scan failed during medication administration.
Item: [WRISTBAND / DRUG NAME AND LOT IF AVAILABLE / DEVICE ID].
Problem: [WHAT HAPPENED, e.g. pharmacy label on IV bag does not read on 2 scanners].
Doses affected so far: [NUMBER].
Manual verification was completed and documented for each dose.
Requesting: [new wristband / relabel / device repair / network check].
[YOUR NAME], RN, ext. [PHONE]

Words to avoid

Word or phrase Why it hurts Use instead
override (alone)Says you skipped the check. Nothing moreThe specific failure plus what you checked
scanner down / system issueToo vague to prove anything or get anything fixedWhich device, how many attempts, ticket number
unable to scanDoesn't say if the band, the drug or the device failedwristband barcode unreadable / drug label barcode unreadable
verified pt (with nothing after)Doesn't say howname + DOB verbalized, matched to wristband and MAR
per policyNobody can tell which steps you actually didName the steps
given per MARHints at a check without describing onelabel checked against MAR: drug, dose, route, time
other (in a dropdown)Keeps the cause out of failure reportsThe most specific option, plus free text

The override reason that only names the failure

Most of the time the override box gets one phrase: scanner down, unable to scan, override. Whoever wrote it probably did a careful manual check. You'd never know from the chart.

Here's what a reviewer sees after a med event. The BCMA log shows a skipped scan and a free-text reason. If that reason only names the failure, the record says the safety check didn't run and nothing ran in its place. A careful manual verification and a rushed pass look exactly the same. You remember it clearly today. You won't in eighteen months. By then the chart is all anyone has.

There's a second problem. Override reasons usually end up in reports, and some systems track unable-to-scan events on their own. Pick other and the broken scanner stays broken, along with the pharmacy label that never reads. Give a specific reason and someone can actually fix it.

Bottom line

When the scan fails, chart the check you did by hand. Naming the failure isn't enough.

Official guidance

  • The scan does two jobs at once. It confirms you have the right patient, and it confirms that patient is getting the right drug. When it fails, you still have to do both jobs and chart both. (PMC, HealthcareBC Cerner Help.htm))
  • Products that won't scan, or show up without a usable barcode, are a known system failure. They get tracked and reported. Tell pharmacy. Don't quietly override the same item every shift. (Pennsylvania Patient Safety Authority, VA BCMA User Manual/psb_3_um_chapters_1_thru_4_r0109.pdf))
  • Workarounds that make it look like the scan happened are documented safety threats: a patient barcode stuck to a cart or a doorframe, meds scanned ahead for several patients. They take the check away and leave no sign it's gone. (PMC, Nurses Educator)

What this rests on

No published decision turned up for this question. We looked, and the searches are in the record. So this article stands on published guidance and on how the question is asked on the floor, not on a court opinion. That is a weaker footing than the rest of the guide, and you should know it before you rely on it. The decisions behind the other articles are all in one place.

From nurses online

Quoted as written. Opinion, not a source.

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