1. Planning your hospital day including administration of Medications Using eMar Get report from nurse Check Dr. orders to see changes since you checked the chart last

2. Verify that the patient’s Medication Administration Record (MAR) is consistent with the physician’s orders. Do this early in the day of your clinical experience. The MAR will have the date the medication was ordered so you can go to the physician’s orders for that date. Your instructor may or may not ask you to demonstrate how you checked the orders.

3. Print a MAR Select 6 to print a new MAR worksheet the day of care; REMEMBER, the one printed the day before is not necessarily up to date. New orders may have been entered. Give medications from the computer, not the worksheet.

4. After select 6 Press enter a couple of times till the print on appears at the bottom of the screen

5. Press space bar and a number for a printer appears Press enter and the MAR will print. Sometimes you have to put in the printer # located in the front of the printer. You now have a MAR Immediately remove any identifying data! Remember HIPPA!

6. Select 7 Status Board From status board go to Mana g e list (or g) Space down and enter your patients room number. Ie: D. 201 then bed A Press enter and this board will appear with your patient Hint you can do this the day your patient is assigned and it will be there the day of care

7. From this board you can view: Allergies A dmission data P rocess interventions or your assessment Patient N otes M AR Rev I ew where you can find lab data that you may print out by selecting print. Cut off identifying data. HIPPA

8. First thing on your shift, recheck the MAR for new orders check the patient’s medication bin to make sure you have everything you need. You may need to order missing medications. For eMar, you order missing meds through the computer: have your instructor show you how to order missing meds. It can take an hour to get them so order early.

9. Your meds are a high priority Proceed with your v.s. and assessment, taking into consideration the time you have to deliver meds. Try to prepare meds ½ hour early

10. Order Of The Day Introduce yourself Identify the patient Discuss the plan of care of the day. Ie: “I will be taking your V.S.,doing you’re a.m assessment,helping with you’re a.m. care, & ambulating you. Do you have any needs or concerns?”

11. Order Of The Day Take your patients V.S. Put the machine back in the hall for another student to use

12. Blue is an ORAL themometer Red is a RECTAL themometer

13. Order Of The Day Start your assessment An easy way to visualize the body is when you help them with a bath.

14. Focus on incisions, IV sites, etc. Complete the a.m. assessment This imperative to complete in order for you to know what the patients status is. If there is a negative change in status the Dr. needs to be notified.

15. Order Of The Day After leaving the room make notes on all abnormal findings Write a draft of the exceptions to normal findings Have your instructor look at your notes

16. Order Of The Day Go to P rocess I nterventions Document you’re a.m. assessment The goal is to have this completed by 9:30

17. Double check the MAR Be prepared to give 10 am meds at 9:30

18. Giving Meds Wash your hands, gather the medications you are to give, make sure you have everything you need, notify your instructor that you are ready for supervision. Have your med marked in the book or the write- up of the medication.

19. Right Med Perform three safety checks. eMar helps you do this: a) when you get the medication out of the drawer you can check against a current worksheet, b) when you scan the medication, c) as you scan, read the label.

20. when you scan the medication Consider highlighting the med you plan to scan for a double check

21. S can M edications Enter SM into the upper left box

22. This screen will appear hit enter till your med screen reappears You are ready to scan

23. as you scan, read the label If the scanner will not read the barcode your instructor will help you F ull D ocument

24. Sometimes this screen will appear when you are giving 2 pills, ½ tablet etc. Note dose ordered 650mg Dose administered reads 325mg Dose administered can be scanned in or entered from the keyboard. Dose administered is the dose the Dr. ordered and that you are giving 650mg

25. make the last step of confirming that all of the medication for that time have a check by them. Remember to use F12 or say Yes to file. Verify Patient screen will appear Now you are ready to Identify the right patient

26. Right patient Ask their name Verify their name on their armband Verify another number like medical record number or birthdate Scan their band

27. Before giving medication CHECK THE ARMBAND. Ask the patient their name and birthdate. Failure to check the ARMBAND could result in withdrawal from the program. Scan the patient's arm band before giving the medications. Bypassing the system IS failure to check the armband. If the patient does not take a medication after scanning use Undo Documentation if you plan to give it later, Edit Documentation if you won't give it later.

28. Make sure you have filed the medications after you scan the patient. Look at the screen and verify if the meds you gave went away &/or were retimed. Press F11 to exit

29. Consider: If the med is a PRN medication verify the time it was last given. And whether the appropriate interval of time has elapsed In this example the med was last given at 0956. It was 1559, so more than 4 hours had elapsed since he received the med.

30. YOU MAY NOT ADMINISTER MEDICATIONS WITHOUT YOUR INSTRUCTOR UNTIL YOUR INSTRUCTOR GIVES YOU PERMISSION TO DO SO. The same will be true in subsequent nursing courses. You may administer medications that have been checked by a staff nurse only after your instructor As a student you will never administer medications without having them checked by a licensed person.

31. For eMar, when you draw up a medication, like Insulin, before scanning the medication, you MUST keep the vial with the syringe until you have scanned the vial. Otherwise you don't know the medication came from the vial you scanned.

32. For eMar, never bypass the system and give medications without scanning the medication and scanning the patient's armband. If the patient doesn't have an armband or the armband doesn't work, get an armband before giving medications.

33. Use shift F12 to suspend the session and cover the screen to protect the patient's privacy.

34. Chart appropriate information about PRN medications, "held" medications, refused, or late medications in Pt N otes Consider the information to enter in the note: Data Action Response Teaching

35. Frequently communicate with your coassigned nurse Always Report off to your coassigned nurse at the end of the shift

36. This powerpoint is only a brief overview of what your day may look like If you are prepared to care for your patient and have the basic organization down your learning will increase dramatically! Looking for caring, effective and efficient nurses!!!