Electronic Medication Administration Covering ICU’s Medication Rights

Introduction 

Within the ICU, medication administration processes entail ensuring that all healthcare experts work together to avoid incidences of error. The electronic medication administration systems (EMASs) are sophisticated systems comprising of software, scanners, computers, medication dispensing robots, and barcode printers among other materials and utilities. Presently broadly implemented, EMASs facilitate in managing medication in an effort to minimize errors related to medication, improve safety of patients, and boost efficiency of workflow (Lapkin, Levett‐Jones, Chenoweth, & Johnson, 2016) . Nurses are among the largest EMASs users while they are regarded as the last defense line in hindering errors in medication in acute care settings, such as ICUs. Thus, EMAS should ensure to support the medication efforts of the nurses without the need for ‘workarounds,’ challenges in navigating application, or other challenges related to usage. Nonetheless, all healthcare professionals should have the capacity of performing the distinct successive duties to allow them complete vital activities related to administering medication in ICUs and other critical areas (Risør, Lisby, & Sørensen, 2016) . The purpose of this paper is to reveal how electronic medication administration records cover the rights of medication in the ICU.

History of Topic 

The person credited with the first idea of the EMASs concept served as a nurse at VAMC (Veterans Affairs Medical Center), Topeka, Kansas. The nurse introduced the barcoding technology aimed at fostering the administration of medication. During 1994, she believed that since a rental car technology used the technology in an effort aimed at tracking cars in line with tracking, it would also be possible to utilize it for tracking medications administered and orders for patients. The idea that she introduced regarding checks and balances via electronic means later grew to emerge to what is presently known as BCMA. During 2003, the distinct areas at VAMC managed to identify patients positively. The BCMA technology paved way for EMASs, which started operations during the early 2000s. The official implementation of barcodes for medication purposes and identifying patients commenced in 2007 (Westbrook, et al., 2015) . These have played a critical role in minimizing error rates associated with medication administration in ICUs significantly. Presently, the systems serve as standard practice in diverse acute care environments.

Topic Becoming Electronic (Part of Nursing Informatics) 

At the JCIA (Joint Commission International Accreditation) in 2006, challenges prevailed in identifying an administration record for a single patient drug. This resulted to the emergence of an idea for having electronic records for the different patients and care providers thereby leading to a requirement for an electronic record. Three key applications were proposed for electronic records. These comprised of EMAS (electronic medication administration system), COPE (computerized physician order entry), and clinical documentation. These influenced the safety of the patients in differing ways via reducing unnecessary and incorrect medications and treatments and boosting care timelines. These applications differed in terms of the benefits they presented based on the sequence of administration while differing organizations deploy them as distinct initiatives. Others might decide to adopt them all at once. Consequently, it was decided that each application needed initiating separately. For the COPE, it facilitated in prescribing medication, order review relating to medication, and dispensation, which was deployed in 2005. The adoption of EMASs followed after proposals for designing and creating a system that would ensure safe administration of medication were made (Risør, Lisby, & Sørensen, 2016) . This would serve as the first step toward having a system that would assist in tremendous error reduction related to medication administration, particularly at ICUs.

Technology Implementation in Healthcare and Target Group 

The deployment of the EMAS technology in the healthcare required the adoption of systems and expertise that would contribute toward the different medication administration needs. The patients needing critical care serve as the most threatened. Errors during medication administration would result to fatal repercussions, including death. The implementation of the electronic medication administration aimed at minimizing errors when administering medication. The machines used in this case aim at making sure that patients usually receive the medication they should receive and at the time that the system indicates. Here, the care quality increases while the patients’ survival chances improve, particularly those receiving critical care (Vicente Oliveros, et al., 2017) . The ICU serves as among the areas that patients need critical care.

Technology Impact on Personal/Professional Practice 

To operate in the ICU (intensive care unit) when serving as a nurse is a daunting task. The reason for this is that an individual is forced to deal with a large number of vulnerable patients whose survival chances are quite limited. Whereas the electronic medication systems take a considerable amount of time, they feature increased accuracy levels that make it possible to eradicate incidences of error. In this vein, is becomes possible to make sure that the care that patients receive is of high quality. For nurses, they realize increased satisfaction both professionally and personally. Additionally, the processes and the machines involved in this practice make it possible to boost the nursing profession’s nature. As such, the electronic medication systems have allowed me to realize increased satisfaction levels in my professional area of practice, which is nursing.

Advantages and Disadvantages 

Advantages 

The electronic medication administration systems feature various benefits and drawbacks to patient safety, quality, patient care, and workflow among others. On the advantages, the machines normally ensure that patients receive medication in the needed time. This facilitates in error reduction when administrating medication in the ICU. This is particularly the case when it comes to errors associated with ideal medication machines and administration time. Additionally, they make it possible to boost documentation compliance in medication administration within the ICU (Thompson, et al., 2018) . In the event of a considerable nurses operating at the ICU, they feel that the systems boost satisfaction in the workplace while at the same time improving their professionalism through increased accuracy, efficiency, and security.

Additionally, the electronic medication administration systems, they boost administration of records in line with offering accurate drug’s administration time. It boosts the safety of patients and idea identification of drugs through the barcoding system (Risør, Lisby, & Sørensen, 2016) . To boost the option of safety further, the systems have been created in a manner that they mark when a patient has actually received a drug received thereby contributing to increased reliability. The system has compulsory options for entering comments in case of missed or delayed administration (Lapkin, Levett‐Jones, Chenoweth, & Johnson, 2016) . This assists the nurses at the ICU to identify for causes later and take a corrective action. Aside from the safety of data and the patients, it is also possible to realize additional complementary benefits, including saving of the space for storage and cost benefits. Whereas it is not possible to realize the benefits easily, they become apparent after computerizing all records of patients. Moreover, the ICU realizes the benefits of an ideal interface with international and national systems afterwards, which would ensure that smooth operations of the center.

Furthermore, the streamlined status of the software and other materials and utilizes within the ICU provides nurses, physicians, and other medical practitioners to see the data of patients more visually, including charts and graphs. With this form of information, it is possible to access it both offline and online while sharing it with medical professionals and patients internally and externally with insurance companies and pharmacies among other involved parties automatically. With this form of technology, it is evident that it can offer numerous benefits (Vicente Oliveros, et al., 2017) . Hence, it serves as a vital platform that would facilitate in changes that would take place in the ICU in the future.

Disadvantages 

For the electronic medication systems, they are sophisticated in terms of their nature while they handle numerous functions in the ICU. For the nurses together with other personal working in the ICU, they are required to complete the entire processes that the systems direct. In the event of medication administration, for example, the process can take a considerable amount of time since it might require the completion of around 20 steps. The decentralization of the warnings and alerts by machines might lead the departments to become confused. When it comes to an overdose error, when the I.V. fentanyl prescribed is relayed. During certain instances, the nurses might follows the processes while utilizing machines, which might lead conflicts to result from the ICU (Thompson, et al., 2018) . Numerous errors attributed to administration of medication might result during busy instances leading to missing of certain steps, which might be catastrophic. 

Conclusion 

In conclusion, the electronic medication administration systems have contributed greatly to the medication administration in the ICU. Since their emergence, they have resulted to various benefits in the ICU, including reducing medication errors in ICU, improved the processes of documentation compliance, and increased job satisfaction and professionalism among other advantages. The systems have also contributed to professional and personal advancement to nurses working in the ICU. Nonetheless, various drawbacks have emerged, such as conflicts in critical care, workload burdens among ICU nurses, and decentralization of machine warnings and alerts. Nonetheless, the machines have done a great job in error reduction in ICUs. In this sense, with the ongoing evolution of the machines, it would be crucial to invest in revolutionary technology that would assist the care providers in offering medication administration solutions for all people in medical care and improve the care of the patients.

References

Lapkin, S., Levett ‐ Jones, T., Chenoweth, L., & Johnson, M. (2016). The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews. Journal of Nursing Management, 24 (7), 845-858.

Risør, B. W., Lisby, M., & Sørensen, J. (2016). An automated medication system reduces errors in the medication administration process: results from a Danish hospital study. European Journal of Hospital Pharmacy, 23 (4), 189-196.

Thompson, K. M., Swanson, K. M., Cox, D., Kirchner, R. B., Russell, J. J., Wermers, R. A., & Naessens, J. M. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2 (4), 342-351.

Vicente Oliveros, N., Gramage Caro, T., Pérez Menendez ‐ Conde, C., Álvarez ‐ Díaz, A. M., Martín ‐ Aragón Álvarez, S., Bermejo Vicedo, T., & Delgado Silveira, E. (2017). Effect of an electronic medication administration record application on patient safety. Journal of Evaluation in Clinical Practice, 23 (4), 888-894.

Westbrook, J. I., Li, L., Lehnbom, E. C., Baysari, M. T., Braithwaite, J., Burke, R., & Day, R. O. (2015). What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system. International Journal for Quality in Health Care, 27 (1), 1-9.