1. Supervisor Orientation to BMV & eMAR Definitions: BMV = Bedside Medication Verification eMAR = Electronic Medication Administration Record By Charlotte Snider RN

2. Will BMV save you time? Probably Not! So why bother with BMV? Patient Safety!!!!

3. The system will perform all checks electronically for: »Right patient »Right medication »Right dose »Right time »Right route Also checks for allergies and expiration date of medications.

4. First let’s cover how to get around on the new screens The status board has a column indicating when the next medication is due There is a ‘MAR’ button on the status board to access the process medications routine Go to the Status Board on your main menu.

5. Status Board This column displays when the next medication is due. The MAR button will take you to the Process Medications Screen. After clicking the MAR button, you will be prompted to enter your password again/

6. Now let’s review the eMAR.

7. This is the eMAR, the electronic Medication Adminstration Record.

8. Now let’s look at the different components of the eMAR. We will start with the top portion. Patient name, age, sex, and date of birth. Clicking on the caduceus will show you the attending, admitting, and family physicians and their information. Allergy information entered into the pharmacy module. Height and weight entered into Meditech. Account and unit number of the patient. Patient location. Admission status. Creatinine clearance results would show here if there were any. Any adverse drug reactions entered into Meditech.

9. Now we will look at the section just above the medications, the column headers. Meds you have selected will have a √ in this column. Medications that have been “Acknowledged ” will display with the letter “A” in this column. This column will display the Start and Stop dates of the medication order. It will also display the status of the medication, “Active”, “Held”, etc. By clicking on any of these boxes you can determine how the medications are sorted, alphabetically, by route, by schedule, see if they are linked to any other medications, administration notes, and administration criteria. These columns display the schedule of the medications, the last administration, the next administration.

10. Here on the medication section you can see which doses have been administered, the times are “gray”, the next scheduled dose is “black”.

11. On the right side of the screen are function buttons, they allow you to access documentation, notes, etc.

12. The buttons at the bottom of the screen allow you to document the medications, acknowledge them, review drug information, run eMAR reports, etc.

13. Now, how to administer a medication.

14. Pull your patient’s medication(s) from Pyxis. You will need to take a computer on wheels with you to the patient’s bedside, log into Meditech, select your patient, enter the eMAR, SCAN your patient and then SCAN your medications.

15. If the medications you have scanned are not “Acknowledged”, you will be prompted to Acknowledge them before you can document the administration.

16. This is the Pharmacy (PHA) Order screen. This is where you can view how the medication was ordered in the system and any special instruction attached to the order. This is the screen that will appear when the system asks you to acknowledge a medication.

17. Once you scan the medications, it will place a small barcode in the first column selecting that medication, this will also place and “*” next to the time of the next dose due.

18. Next, click on the “Document” button at the bottom of the screen.

19. Next, this box will popup allowing you to document if the medication was given or not given.

20. You will notice that there is an “*” next to the time that you documented, now click on the Submit button on the bottom of the screen.

21. Once you have documented the medication as given, and clicked on the Submit button, you will be presented with the following window, here you will click on the buttons on the bottom of the screen. If you select “Return to eMAR”, you will be returned to the eMAR without saving the documentation. If you select “Save and Exit” you will save your documentation and will be returned to the Status Board. If you select “Save and Refresh” you will save your documentation and be returned to the eMAR and it will display that you administered the doses.

22. Do you feel comfortable with the screens so far?????

23. What do all my statuses mean on the process medications screen? *** Indicates more than one action has been taken off the order by pharmacy *DCDiscontinue requested by Nurse DCDiscontinued (these will show on eMAR for 24 hours after DC’ed *ADJA request was sent to PHA to adjust the order, ie adjust all times *HAHold acknowledgement – sends a message to PHA and lets other care givers know that medication order is in question ERecord has been edited.

24. How do I notify Pharmacy of a Status Change of a medication? On the bottom of the screen is a verb strip, by clicking on the “Change Order” button you can send messages to pharmacy for:

25. What about discontinued meds and meds on hold because nursing has a question about the order/dose, etc.

26. Discontinued Meds Nursing cannot discontinue a medication, it takes a Pharmacist to completely discontinue a medication. When nursing sends a request to pharmacy to discontinue a medication, this is how it will look on the eMAR.

27. If you try to document a dose of a medication that has been discontinued, you will be stopped and prompted to answer why you are documenting an administration.

28. If you try to document an administration of med that has been placed on Hold, you will be prompted to explain why.

29. Once you have all the information you need to take a medication off of “Hold”, click on the Change Order Button on the bottom of the screen and select “Resume Order”.

30. How do I document a PRN med? Scan the medication to select it, and then click on the “Document” button on the bottom of the screen.

32. New Mantra Scan Document

33. SCAN – your medication bar code SCAN – your patients’ bar code on their wrist band Document – any special information required and that you gave the medication.

34. Now let’s look at the What If’s”

35. . What if I scan the wrong medication for the patient I am administering medications?

36. What if I scan the wrong patient? You receive a warning like below

37. What if… The Nurse before me did not document a dose given?.

38. . Let’s start covering different scenarios

39. Now let’s talk about PRN medications.

40. Reviewing Administration Criteria to know how much medication to give: i.e. K+, insulin

41. When a patient refuses to take a medication.

42. I have to give ½ of a pill or the ordered dose requires that I scan two or more unit doses

43. And finally Do not work around the system. This is detrimental to: And could be subject to disciplinary action PATIENT SAFETY