ELECTRONIC MEDICATION ADMINISTRATION RECORD (EMAR)
EMAR: BARCODE BASED MEDICATION DELIVERIES
In a traditional paper based medical environment the Medication Administration Record (MAR) is a paper log which is updated every time a patient is given a dose of some medication. This process can be time-consuming and prone to human error. It is also difficult to mine for actionable information, such as consecutive missed medications. Additionally, on the jail floor, it is cumbersome for a nurse to deal with sheets of paper and detailed medication schedules, especially with an inmate (or line of inmates) waiting for medications right in front of her.
An eMAR replaces this system with a computerized barcode scanning process:
- Providers write medication orders using HealthSecure
- Nurses make the rounds with medication carts and a small laptop
- An inmate’s ID is scanned, which immediately pulls up his list of scheduled medications
- The nurse scans each of the inmate’s scheduled items in the cart and administers them
- The nurse then proceeds by scanning the next inmate’s barcode ID
In HealthSecure, this is a fast and accurate process. Apart from verbal interaction, trained nurses are using this system to process about two inmates a minute. They don’t waste time leafing through long paper lists to find the next inmate and his medications, and don’t waste time recording the outcomes of each delivery.
The benefits of this process are many:
- The process is less prone to human error, therefore safer for the patient. Improved safety leads to lower liability, a more contented inmate population, and a better jail environment.
- The system tracks many kinds of “exception” events such as missed deliveries and refusals. This becomes actionable information: for example, a Physician/Provider can see and act upon consecutive non-standard delivery outcomes to a specific inmate.
- Nurses can complete floor deliveries more quickly. This improves morale for both nurses and deputies, which can help with employee retention.
- The original paper “MAR” is just a historical log of which medications were administered to a patient, at what time, and by whom. This barely begins to describe the spectrum of functionality that is available in HealthSecure.
These are just some of the scenarios our software handles:
- Inmate refuses medication:
- A variety of detailed reasons can be captured, allowing the Physician/Provider to know exactly why, and respond appropriately. Was it because the inmate was combative? Or the medication had side effects? Quickly knowing what happened on the floor is a game-changer for providers.
- Inmate refuses medications … but changes his mind.
- Inmate is absent: capture reasons, such as “at court”
- PRN (as-needed) medications
- Keep-on-Person medications, for approved inmates – a time saving feature
- Urgent Medications delivered from the institution’s own stock, for orders which have not yet been received from the pharmacy
- Re-delivery of missed medications
- Partial delivery of medications
- Management of “Home Medications” brought by the inmate’s family to the jail. This can be a cost and time saving feature.
The nurse on the jail floor has a tough job. In addition to delivering the scheduled medications in challenging surroundings, she also has to deal with situations that are unique to a jail. These situations require the nurse to think on her feet and to sometimes make clinical decisions based on the jail’s established protocols.
Our system aids the nurse at every step of this process on the floor. Scan the inmate’s ID, and the screen immediately shows his photo so she can confirm this is the correct person and view his medications. Scan each medication – the MAR is updated instantly. This allows her more time to deal with unusual scenarios that may occur. In current production use trained nurses are processing about two inmates per minute with this system.
Providers are empowered with better data about the medication delivery outcomes and unusual patterns. All this can lead to inmate safety, with attendant benefits such as reduced liability and an enhanced jail environment.