RIGHT MEDICATION, RIGHT PATIENT,  RIGHT DOSE
eMAR Prevents Medication Errors.


Doylestown Hospital continues to work proactively and aggressively toward the reduction of possible medication errors. Our latest step is the implementation of an Electronic Medication Administration Record (eMAR). A fully-integrated software, eMAR marries two technologies: Bluetooth(r) wireless and hand-held scanners to read bar codes: the same bar code technology used in supermarkets. Individual dosages of drugs are bar coded in the Doylestown Hospital Pharmacy, then tracked from the Pharmacy to the Nursing Unit to the patient's bedside.

Doylestown Hospital worked with Meditech, a specialized healthcare software provider, on the development of eMAR for almost two years, ultimately becoming a beta site to test, develop and implement the custom-designed eMAR software. A multidisciplinary team of more than 25 Doylestown Hospital Associates, including staff from Nursing, Pharmacy and Medical Information Systems (MIS), assisted Meditech in building the system.

"Actually," says Carol Muhlbauer, Doylestown's eMAR project coordinator, "we can truthfully say because we were a beta site and the first to go-live with the software, we are the first in the world to use the Meditech product. And, implementing eMAR is the first step toward our goal of having a fully integrated electronic medical record system."

At admission, all patients are given bar coded ID bracelets to be used for identification. The nurse scans a patient's bracelet at the bedside before medications are administered. If the nurse scans the wristband and medication, and the software detects a medication interaction, incompatibility or allergy, the eMAR system alerts the nurse. It also prompts the caregiver to check clinical information related to certain medications. During the first two weeks of using eMAR, 90,000 medications were scanned; 6,000 alerts were noted with 1,200 having clinical implications.

EMAR ensures easy tracking of medications from the physician's order, to the Pharmacy, to the floor's medication carts, to the patient. Other local hospitals use components of Meditech's eMAR system, but none use the bar coding like Doylestown does.

Doylestown Hospital's investment in the eMAR system was more than $500,000. But, according to Patti Stover, Director of Patient Services, "The investment has been more than worthwhile. Nurses and physicians alike have gratefully wrapped their arms around the project. Knowing that medications are administered in the right dose at the right time to the correct patient is integral to ensuring medication safety and supports our culture of patient safety.


The Medication Administration Process Using eMAR

• A Physician writes the order, which is sent to the Pharmacy.
• A Pharmacist enters the order in Meditech
• The Pharmacy bar codes the medication and distributes to the floors.
• The nurse views the eMAR screen and reviews the patient's medication list and verifies with the physician orders.
• eMAR alerts the nurse about the next dose due, overdue doses, or cautions about medications
• Nurse takes the cart to the patient, scans the medication and the patient's wristband.