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From left, Ramona Nee, RN, Anne Bane, RN, Susan McDonald, RN, Alisa Johnson of IS, and Jessica Dion, RN, during the Tower 6BD roll out.
As part of the hospital's goal to provide a safe environment for patient care, BWH’s electronic medication administration record, or eMAR, is rolling out on Oncology patient care units this fall.
In 2005, when eMAR was implemented in most of the Tower and CWN, Ramona Nee, BSN, RN, was trained as a “super user” to teach others how to use the new system.
“I saw how well it worked and how it promotes patient safety,” said Nee, who has been an Oncology nurse at BWH for 23 years. “I was so excited for it to come to Oncology.”
Last week, eMAR made its much anticipated debut in Hematology/Oncology/Bone Marrow Transplant after extensive collaboration among IS, Nursing, Pharmacy and Medicine to work out how the complexities of chemotherapy administration could fit into eMAR.
The phased roll out marks a milestone for BWH, which is internationally known for its revolutionary system linking order entry, pharmacy and the medication administration record to improve patient safety. Since bar coded medication distribution and administration system began in early 2000 and eMAR went online in the Tower and Connors Center in 2005, targeted pharmacy dispensing errors have been reduced by 85 percent and potential adverse events by approximately 63 percent.
“Our patients have an added comfort level with the implementation of eMAR,” said Gina Cappelletti, BSN, RN, of 6A Bone Marrow Transplant Intensive Care Unit, a super user for the 6BD roll out. “They feel assured that they are receiving the correct medications.”
eMAR came online in Tower 6B and 6D last week. A phased roll out is planned, bringing all Oncology pods online over the course of the next few months.
The transition from paper to eMAR in Oncology has been three years in the making as nurses, physicians, pharmacists and IS staff have been collaborating to revamp the Chemo Order-Entry system in order to add chemotherapy administration into eMAR.
“Chemotherapy is more complex than other medications,” said Anne McDonnell, PharmD, BCOP, clinical pharmacist. “A chemo regimen often involves four to five additional medications administered in a specific time sequence.”
Hydration and anti-nausea medications often precede chemotherapy, and those needed to be taken into account in eMAR. The system will provide prompts for nurses at the correct times to administer each medication.
After chemotherapy was built into eMAR, Tower 6D piloted the new system in July for two weeks. “The pilot was really important because we found a lot of enhancements we could make so that eMAR is in sync with nurses’ workflow,” said Bayn Baxter-Smith, IS application analyst.
IS built in a chemo card for each patient in eMAR so that clinicians have at their fingertips a big-picture treatment plan, including all medications and dates and times of administration. Another link takes nurses to online resources so that they can learn about a medication or treatment without looking for a reference book.
During the roll out, Nee and other super users, as well as staff from IS, will help nurses learn to use the system and be available for trouble-shooting as needed.