S3 2019 Technology and Operations Poster Winner - DIY Electronic Medication Administration Record
Medication administration is an essential component of nursing student education. Oral medication administration workflow can occur through a traditional paper-based record or a digitized record. In the absence of a suitable off-the-shelf training platform, a team from the School of Health and Social Sciences a t Nanyang Polytechnic, Singapore, developed their own electronic medication administration record (eMAR) training platform. Their ingenuity won them the best Technology and Operations Poster category at the S3 conference held in Singapore in October 2019.
View their poster here, or read the description of their winning project below.
Nanyang Polytechnic Low-Cost electronic Medication Administration Record (eMAR)
The introduction of electronic medication records (eMAR) in the hospitals in Singapore made it crucial that nursing schools updated the method of teaching administration of oral medication to nursing students.
Existing commercial off-the-shelf products are unable to address the following - include the diverse and unique workflows of the 3 integrated health clusters of Singapore hospitals, allow ease of access to every nursing student and be priced at a reasonable cost.
To ensure that all Year 2 students are competent in the administration of medication, the School of Health & Social Sciences (SHSS) at Nanyang Polytechnic (NYP) developed the SeNS - School of Health & Social Science electronic medication record for Nursing Students. The SeNS simulates a real clinical eMAR system which consists of elements and functionalities such as:
- Pre-programmed self-populated fields
- Decision support such as prompts for wrong timing, medication or patient,
- Utilization of alpha-numeric barcodes for patient identification and medication
- Embedded checkpoints to enable closed-loop medication process emphasizing principles of medication
Hardware and Software
A notebook with Microsoft Excel, off the shelf barcode scanner and hospital-grade mobile cart were required for the project. Both hardware and software components of the SeNS are mounted on hospital-grade mobile carts Egotron to replicate its use and appearance of a clinical workstation on wheels (Picture 1). Visual Basic for Application (VBA) embedded in Microsoft Excel was used to create the user interface with automated defined processes and decisions.
Picture 1 depicts the set-up of a clinical workstation on wheels
Tables and Worksheet
- Tables were created to store Patient Information, Medication and Prescription.
- Worksheet (Figure 1) that displays Patient and Prescription interface.
- The function “VLOOKUP” is used to self-populate data from the table to the worksheet.
Figure 1 illustrates patient information and prescription
User Interface (Userform)
Controlling user data entry to prevent wrong workflow is vital in avoiding unnecessary processes. The user interface (userform) is created with VBA Codes which trigger events and prompt messages when an error occurs.
A pop-up userform (Figure 2) allows the user to select the desired patient from the list or by scanning the patient identification which has a corresponding barcode.
Figure 2 userform identifying patient list
The SeNS system has allowed learners to experience and practice the digitized medication workflow at their own convenience and pace. Further exploration is needed to develop a user interface for faculty to create medication administration scenario rather than inputting data into the tables. These will minimize unnecessary data entry and allow reusable medication prescription for different patients.