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Table 5 Key behaviours involved in using EMMS to administer medication

From: Applying the Theoretical Domains Framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitals

Behaviour ID Key behaviour
B1 Nurses endorsed to do so use the EMMS to administer medication.
B2 The administering nurse logs into the EMMS and opens the patient’s eMAR.
B3 When leaving the eMAR, the administering nurse logs off the eMAR or changes user.
B4 Open a single patient’s eMAR at a time. With only their eMAR open prepare medication for one patient at a time immediately before intended use (includes medications requiring a second person check or witness).
B5 Check the eMAR to identify when medications are due.
B6 Check the eMAR to ascertain when the medication was previously administered.
B7 Within scope of practice limitations nurse select medications in the eMAR.
B8 Check medication preparation and administration instructions and alerts/icons in the eMAR.
B9 Check the purpose, action and safe dose range of the medication to be administered prior to administering the medication.
B10 Complete associated medication-related tasks and enter information in the eMAR prior to administering medication (e.g. blood glucose level, blood pressure, heart rate).
B11 Check medication-associated test results (e.g. electrolyte levels) on the system prior to administering medication.
B12 Take an eMAR to the patient to check the 5 Rights of medication administration prior to administration of a medication. Check the 5 Rights of medication administration against the patient’s eMAR and the patient prior to administering medication.
B13 Ascertain that the patient is not allergic to the medication to be administered by checking the patient’s allergies listed in the eMAR and with the patient prior to administering the medication. This requires that a responsive eMAR be taken to the patient when administering medication.
B14 Medications requiring a witness: a responsive eMAR must be taken to the patient to check the 5 Rights of medication administration prior to administration of a medication. Check the 5 Rights of medication administration against the patient’s eMAR and the patient prior to administering medication. In addition, preparation, administration and discarding of unused medications must be witnessed and the witness must enter their username and password in the eMAR following medication administration and discarding of unused medication (at the time of medication administration).
B15 Medications requiring a second person check: a responsive eMAR must be taken to the patient to check the 5 Rights of medication administration prior to administration of a medication. The administering and checking nurse check the 5 Rs verifying the patient identification, allergies and order in the eMAR. The administering nurse is logged into the eMAR, and the details of the checking nurse should be recorded in the eMAR at the time of medication administration.
B16 Assess whether it is safe to administer medication (is there any reason why the medication should not be administered (e.g. oral medication when patient is unconscious; administration of medication is contraindicated on the basis of tests, fasting, etc).
B17 If appropriate (see B16), administer medications according to a time frame prescribed in the eMAR.
B18 Relevant information about medication administration is recorded and communicated. Medication administration is to be recorded in the eMAR by the administering nurse once it has successfully been administered (at the time of administration). Oral medication must be observed to be consumed by the patient before the administering nurse enters it as administered in the eMAR. Unadministered medication should be recorded accordingly—‘not given’, ‘withheld’, ‘rescheduled’, ‘delayed’ and a reason entered. If a variable medication dose is ordered, the dose administered should be recorded in the eMAR. If the administered dose is different from the prescribed dose, the amount administered and the reason for the difference should be entered in the eMAR.
B19 When the administration information has been entered, the screen should be refreshed/the eMAR closed.