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Problems with MAR within Electronic Medical Records conversion

By Laura Withorne-Maloney posted 05-18-2011 02:35 PM

  
Our in-patient behavioral health unit is struggling with medication adminstration using a total electronic MAR system in a behavioral health setting. BHC leaders recently met with pharmacy as pharmacy says our paper MARs need to go away asap. Since going electronic 4 or 5 years ago, we have made some attempts to transition away from paper, however, have been met with multiple challenges and attempts ultimately deemed unsuccessful. When we met with pharmacy, we had asked them if they could help us locate an inpt BH center of our size, using a total electronic system to see how they are doing it. So far, we haven't heard anything back. (Avera Behavioral Health Center, Sioux Falls, SD, is a free-standing BHC facility with about 120 total in-patient beds:Seniors, Acute adult, Adult, Child and Adolescent units, plus 2 out-patient clinics, ECT suite, Research, and some day programs including Parital Hospital program.  www.Avera.org )

The problem is that it is not safe to have computers in each patient room like at the main campus to document, and not all of our patients are able to come up to the med windows to get their meds. We use the paper to make sure we can do proper identification and dispensing. We have tried small palm pilots, but they are too small and you were not able to batch your documentation so you didn't have to document each individual med, but rather as a batch. We also tried a very small laptop, also not very successful as function was more limited/restricted than on a regular desk top computer. The idea was recently brought up to try ipads and so we have entertained the idea of a trial with them.  We have been told the paper will go away when we move to electronic physician order entry and documentation and that will happen in January of 2012...

I am wondering if anyone out there has or is experiencing this kind of problem with conversion to the Electronic Medical Record and how this problem was overcome?  Thanks for any advice offered!   Laura Withorne-Maloney, CNP
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Comments

Patricia Jackson
12-10-2011 09:43 PM

Like John we use CERNER. We have 69 adult, geri and adolescent beds. Our nurse use a handheld device to administer meds in patient rooms or wherever the patient is if they are unable or unwilling to come to the nurses station for their meds. We have more trouble getting them to keep their armbands on than scanning medications. Would be happy to help. Just contact me at pjackrn@gmail.com

Judy Lark
06-07-2011 08:05 PM

We are struggling with the same issues. We are a 16 bed psych unit in an acute care med surg hospital. We currently are using bar coding to administer meds as the rest of the hospital is doing so. We have rolling carts that are a pain to get around and wake patients during the night. We did have one locked wall computer in the dining area but that requires a wireless bar coding system that doesn't work well. At first, we had thought of putting computers in each room but did not end up doing this. Sometimes I think that this may have been the way to go because there are never enough computers to go around. Were going to use tablets, and other devices but cost to pilot was too much. Still trying to think of the best way to go. No one that I have talked to has a system that really works well in mental health.

R. John Repique
05-21-2011 10:23 AM

Laura,
Our mental health hospital has fully implemented CPOE (computerized physician order entry) & eMAR (electronic Medication Administration Record) since 2009. We have 140+ inpatient beds, a comprehensive outpatient department and a free-standing psychiatric ED. We use CERNER. Please feel free to call me and I would be happy to speak with you further and will try to answer some of your questions. I can also give you names/contacts with some wonderful nursing informatics colleagues in our Clinical Informatics Department.
John