The Implementation of an eMAR, Research Paper Example

The implementation of an eMAR in the hospital setting is a process that is challenging and most likely going to present with setbacks of some sort. It is important to have an idea of these different scenarios beforehand in order to be proactive and ensure a smoother transition. In the event the project is not working at all in the environment, it is important to acknowledge why and take care of terminating the project before further problems occur.

Ways to Maintain a Successful Solution

The successful maintenance of the eMAR in the CCU will call for the project to actually go ‘live’ in the unit rather than being a research tool. This will entail a complete transition from paper to electronic data and will require communication between all departments of the hospital who have access to the patients in the unit. The paper records will be curtailed after a predetermined time frame determined by administration. This will be overseen by supervisors during every shift in the CCU.

Of all hospital implementation, this will perhaps be the most difficult piece of an eMAR because the CCU is constantly being inundated with patients being admitted or discharged and receiving medications. There will be overtime shifts offered to employees during this time in order to assist the other nurses while they perform normal duties as this will help with stress and anxiety. Informal evaluations will take place every 48 hours by nursing supervisors and there will be formal evaluations by hospital administration every five days until the transition is complete and deemed successful.

Ways to Extend a Successful Solution

Upon successful implementation of the CCU project, it will be beneficial to further implement the eMAR to other sites inside of the hospital. As stated in the original proposal, each department will be transitioned one at a time to avoid conflict with daily tasks or increased employee anxiety. The basic implementation methods as used in the CCU solution can be used for the other departments and minor adaptations will be made as necessary. The same informal and formal evaluations will be sufficient in order to keep the lines of communication open between staff and administration.

Ways to Revise an Unsuccessful Solution

If the proposed solution for the CCU project is not successful, it is important that administration be made aware as soon as possible in order to reevaluation how to improve the plans or adapt the methodology to meet the needs of staff so patient care will not be compromised. Various methods can be adapted with the device itself, such as ergonomically, or small changes in the mechanics of operation can be adapted to streamline workflow. Also, if the implementation is not having the success that administration is hoping for due to the learning curve of staff, overtime shifts will be offered as a way to help with the anxiety and stress while the change is taking place.

Ways to Terminate an Unsuccessful Solution

Due to the implementation in the CCU first, our project will be examined long before hospital wide implementation begins and this will make termination less difficult if the project is deemed unfeasible. Open communication at all times will help with any adaptations that are needed in the event termination is not necessary. If the decision to terminate is made, nursing personnel will be advised to stop entering the information into the eMAR machine and continue with the paper records system. Because the two systems will be used simultaneously, this will not interrupt patient care. The only small interruptions will be upon disassembly and removal of the equipment.

Plans for Feedback and Communication

As stated above, formal and informal evaluations will be used in assessing the success of this project. It is important these evaluations remain unbiased and proper feedback is given and taken into consideration so adaptations can be made accordingly. Based on the literature, there were improvements upon integration of the eMAR into the hospital at St. Luke’s. The most significant there, as well as with Trossman’s article, are the reduction of patient errors pertaining to the administration of medication before and after implementation of the eMAR (Trossman, 2006; Yates, 2007).

Negative feedback will occur and, as based on the article by Moreland and associates (2012), will likely happen due to increased administration of medication on a routine basis as daily tasks are followed and a new system is learned. Providing help will be positive for employee morale and boost the hospital’s reputation as well as decrease chances of errors from employee anxiety. A representative from administration will be appointed as the spokesperson to convey information to the community during the transition every two to three weeks. This will demonstrate commitment to the community by the hospital and will provide information to help local schools and organizations in the future when the hospital is requested to speak or provide information about recent events or implementations to better the health of the community.

References

Moreland, P., Gallagher, S., Bena, J., Morrison, S., & Albert, N. (2012). Nursing satisfaction of implementation of electronic medication administration record. CIN: Computers, Informatics, Nursing , 30 (2), 97-103.

Trossman, S. (2006, Sept/Oct). Preventing errors: IOM report offers strategies throughout the medication process. The American Nurse, 38(5), 14-15.

Yates, C. (2007). Implementing a bar-coded bedside medication administration system. Critical Care Nursing Quarterly , 30 (2), 189-195.