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案例研究:使用电子给药记录提高长期护理机构的用药安全性和效率。

Case Study: Using Electronic Medication Administration Record to Enhance Medication Safety and Improve Efficiency in Long-Term Care Facilities.

作者信息

Fei Liping, Robinson Jenny, Macneil Andrea

机构信息

RAI MDS Manager, The Brenda Strafford Foundation, Calgary, AB.

Chief Operating Officer, The Brenda Strafford Foundation, Calgary, AB.

出版信息

Nurs Leadersh (Tor Ont). 2019 Jun;32(2):102-113. doi: 10.12927/cjnl.2019.25958.

Abstract

The electronic medication administration record (eMAR) has been used in hospitals and acute care facilities in Canada for over a decade. Unfortunately, the Canadian continuing care sector has been slow to adopt eMAR usage. Medication delivery in long-term care has traditionally been through paper-based orders and manual documentation in the paper medication administration record. The effectiveness of this manual system as it relates to medication incidents, patient safety and nursing efficiency is not well understood because most of the information is based on anecdotal evidence. Peer-reviewed scientific literature supports the premise that the eMAR, compared to the MAR, is more efficient, significantly reduces medication incidents, promotes patient safety and improves workflow efficiency. In April 2016, the Brenda Strafford Foundation committed to implementing the eMAR at each of our three long-term care facilities to improve medication delivery, reducing and eliminating medication incidents and evaluating the benefits of the electronic system. Under the direction of the clinical team, including nurses, physicians, pharmacists, and the software provider/vendor, an electronic system was developed and new processes for medication delivery were instituted within eight months of starting the project. Since the past year, the evaluation of the eMAR at the Brenda Strafford Foundation demonstrated a reduction in medication delivery time allowing for more time for direct care and a decrease in medication incidents, which directly affects resident health and safety. Nursing and the healthcare aides trained in medication management were surveyed and indicated that the eMAR provides a holistic view of the resident and provides important information readily available to improve the quality of resident care.

摘要

电子给药记录(eMAR)在加拿大的医院和急症护理机构中已使用了十多年。不幸的是,加拿大的长期护理部门在采用eMAR方面进展缓慢。长期护理中的药物发放传统上是通过纸质医嘱和纸质给药记录中的手工记录来进行的。由于大多数信息基于传闻证据,这种手工系统在药物事件、患者安全和护理效率方面的有效性尚不清楚。同行评审的科学文献支持这样一个前提,即与纸质给药记录(MAR)相比,eMAR效率更高,能显著减少药物事件,促进患者安全并提高工作流程效率。2016年4月,布伦达·斯特拉福德基金会承诺在我们的三个长期护理机构中每个都实施eMAR,以改善药物发放,减少和消除药物事件,并评估电子系统的益处。在包括护士、医生、药剂师和软件供应商在内的临床团队的指导下,一个电子系统在项目启动后的八个月内开发完成,并建立了新的药物发放流程。自去年以来,布伦达·斯特拉福德基金会对eMAR的评估表明,药物发放时间减少,从而有更多时间用于直接护理,药物事件也有所减少,这直接影响到居民的健康和安全。对接受过药物管理培训的护士和医疗护理员进行了调查,他们表示eMAR提供了居民的全面情况,并提供了随时可用的重要信息,以提高居民护理质量。

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