Background Novel information technologies are aimed mostly at reducing medicines errors.
Purpose To develop and implement an electronic medicines administration record (eMAR) in a university hospital.
Materials and methods The study was conducted in a 1118-bed university hospital. Computerised prescription order entry (CPOE) was fully implemented for hospitalised patients.
Traditionally, once the electronically assisted prescriptions have been made, physicians print and sign the medical records in which the nurse will later document administration.
The study was divided into two phases. The first one consisted on designing and developing the eMARs software and took 3 years. This phase was performed by a vendor and by a multidisciplinary team (3 pharmacists, 2 physicians and 3 nurses). The team was required to meet monthly in 2-hourly sessions.
The second phase was a pilot study. The eMAR software was implemented in a medical and a surgical ward. During this phase a pharmacist was in the ward and supported the implementation by training nurses on the use of the software.
Results The most important criteria for designing the eMAR software found in the first phase were:
To link together the medical prescription, pharmacist validation and nurse medicines administration record (MAR).
To remind nurses about medicines that were due for each patient.
To force nurses to document discrepancies between the MAR and the prescription. If a discrepancy was detected it should trigger an alarm to force the nurse to introduce a reason if the warning is overridden.
Both phases helped us to identify and solve some critical failure modes (Table 1).
Conclusions Assembling a multidisciplinary team to design and implement the eMAR and conducting a pilot study were very helpful in identifying and solving critical failure modes.
No conflict of interest.
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