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Electronic Medication Administration Records and Barcode Medication Administration to Support Safe Medication Practices in Long-term Care Facilities

  • Author / Creator
    Fuller, Andrew
  • Abstract
    Medication incidents are common in long-term care facilities (LTCF). While few contribute to permanent disability or death, a significant proportion lead to resident harm. Technology solutions have been proposed to improve medication safety in long-term care environments, with electronic medication administration records (eMAR) and barcode assisted medication administration (BCMA) being a main focus of adoption. However, the impacts of eMAR-BCMA on medication incidents and medication administration incidents (MAIs) within LTCF have not been well defined. The overall objective of this research project was to explore the influence of stand-alone eMAR-BCMA systems on safe medication practices in LTCF.
    In the first study of this thesis, we conducted a scoping review to map the extent, range and nature of research on the effectiveness, level of use, and perceptions of eMAR-BCMA in LTCF. We identified limited direct evidence linking eMAR-BCMA use and reduction in medication incidents and MAIs; in addition to, evidence of new types of medication incidents resulting from nursing staff workarounds, inconsistent influence on nursing time spent during medication administration and an array of perceived benefits and challenges.
    In our second study, we conducted a retrospective review of medication incident reports submitted voluntarily by nursing staff within a single LTCF two years post adoption of eMAR-BCMA, in order to explore the frequency, type and severity of medication incidents; as well as, the characteristics of residents who experience them. We determined that despite eMAR-BCMA implementation, medication incidents and MAIs continued to be reported. The majority of medication incidents were related to improper medication administration practices, communication issues, and pharmacy dispensing errors.

    Our results suggest that more rigorous, prospective research in LTCF and community pharmacies is required to demonstrate the impact that stand-alone eMAR-BCMA systems have on medication safety in LTCF. It also highlights that opportunities remain to optimize use of eMAR-BCMA and improve medication incident reporting in the LTCF setting.

  • Subjects / Keywords
  • Graduation date
    Fall 2019
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/r3-0q22-k166
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.