Question

1. How should medication errors be addressed at each step of the Emar process?

Answer 1

Ans) IT systems are key components of a multifaceted strategy to prevent medication errors and improve patient safety.

- However, we need to be mindful of their potential to affect clinical workflow adversely, with attendant complications.

- Improving standardization and certification of the design and implementation of such systems should help. In addition, creating an economic and policy environment conducive to the financial goals of hospitals and physicians will facilitate wider adoption.

- Computerized physician order entry (CPOE) is a system that allows prescribers to electronically enter orders for medications, thus eliminating the need for written orders. CPOE increases the accuracy and legibility of medication orders; the potential for the integration of clinical decision support; and the optimization of prescriber, nurse, and pharmacist time.

- Decision support software integrated into a CPOE system can allow for the automatic checking of drug allergies, dosage indications, baseline laboratory results, and potential drug interactions.

- When a prescriber enters an order through CPOE, the information about the order will then transmit to the pharmacy and ultimately to the MAR.

- The use of electronic bar codes on medication labels and packaging has the potential to improve patient safety in a number of ways.

- A patient’s MAR is entered into the hospital’s information system and encoded into the patient’s wristband, which is accessible to the nurse through a handheld device.

- When administering a medication, the nurse scans the patient’s medical record number on the wristband, and the bar code on the drug. The computer processes the scanned information, charts it, and updates the patient’s MAR record appropriately.

- Automated medication dispensing systems (AMDS) provide electronic automated control of all medications, including narcotics. Each nurse accessing the system has a unique access code.

- The nurse will enter the patient’s name, the medication, the dosage, and the route of administration. The system will then open either the patient’s individual drawer or the narcotic drawer to dispense the specific medication. If the patient’s electronic health record is linked to the AMDS, the medication and the nurse who accessed the system will be linked to the patient’s electronic record.