College of Nursing, University of Utah , Salt Lake City, UT.
Appl Clin Inform. 2011 Jun 15;2(2):202-24. doi: 10.4338/ACI-2011-01-RA-0004. Print 2011.
Electronic medication administration records (eMARs) have been widely used in recent years. However, formal usability evaluations are not yet available for these vendor applications, especially from the perspective of nurses, the largest group of eMAR users.
To conduct a formal usability evaluation of an implemented eMAR.
Four evaluators examined a commercial vendor eMAR using heuristic evaluation techniques. The evaluators defined seven tasks typical of eMAR use and independently evaluated the application. Consensus techniques were used to obtain 100% agreement of identified usability problems and severity ratings. Findings were reviewed with 5 clinical staff nurses and the Director of Clinical Informatics who verified findings with a small group of clinical nurses.
Evaluators found 60 usability problems categorized into 233 heuristic violations. Match, Error, and Visibility heuristics were the most frequently violated. Administer Medication and Order and Modify Medications tasks had the highest number of heuristic violations and usability problems rated as major or catastrophic.
The high number of usability problems could impact the effectiveness, efficiency and satisfaction of nurses' medication administration activities and may include concerns about patient safety. Usability is a joint responsibility between sites and vendors. We offer a call to action for usability evaluations at all sites and eMAR application redesign as necessary to improve the user experience and promote patient safety.
电子医嘱系统（eMAR）近年来得到了广泛应用。然而，这些供应商应用程序尚未进行正式的可用性评估，特别是从护士的角度来看，护士是最大的 eMAR 用户群体。
对已实施的电子医嘱系统进行正式的可用性评估。
四名评估员使用启发式评估技术对商业供应商的电子医嘱系统进行了检查。评估员定义了七个典型的电子医嘱使用任务，并对应用程序进行了独立评估。采用一致性技术获得了已识别可用性问题和严重程度评级的 100%一致性。评估结果与 5 名临床护士和临床信息学主任进行了审查，他们与一小部分临床护士一起验证了评估结果。
评估员发现了 60 个可用性问题，分为 233 个启发式违规。匹配、错误和可见性启发式是最常被违反的。给药和医嘱及修改医嘱任务的启发式违规和可用性问题最多，被评为主要或灾难性。
大量的可用性问题可能会影响护士给药活动的有效性、效率和满意度，并可能包括对患者安全的担忧。可用性是站点和供应商的共同责任。我们呼吁所有站点进行可用性评估，并根据需要重新设计电子医嘱应用程序，以改善用户体验并促进患者安全。
