Intensive care nurses' experiences with the electronic medication administration record in eRIC

Introduction: Electronic medication administration record systems can overcome many issues associated with paper-based systems, yet can also give rise to new risks and challenges. Goals of such systems are to reduce medication errors, and improve patient safety. In today's health care environment, medication administration is the most complex of all practices performed by nurses, particularly in the intensive care setting. Recently, a new electronic medication administration record (eMAR) was introduced to intensive care units across NSW. The eMAR was incorporated into the electronic information system eRIC, specifically designed for the intensive care environment. The aim of this study was to explore experiences of registered nurses working at one adult intensive care unit (ICU) with the eMAR in eRIC. Method: The study utilised a qualitative descriptive exploratory approach that took place in two stages, one focus group was conducted with five participants followed by the observation of each participant as medications were administered to their allocated patient. Results: From the focus group, three (3) themes and one subtheme emerged from the data. Themes included forcing nurses to work outside legal boundaries, time and patient safety, with a subtheme titled experiencing computer fatigue. Nurses were observed to move across ward spaces to obtain medications thus being forced to leave their patient under the care of another nurse working in the next ICU bay. Overall, nurses felt that the eMAR took time away from the patient at the bedside and 'added more screen time' to their day. To practise safely, ICU nurses were forced to implement workaround practices to resolve challenges that arose when using the new eMAR in ICU. Implications for Practice: This has potential legal implications for nurses' registration and patient safety, should something go wrong. Changes need to be made to the eMAR system in eRIC to avoid adverse outcomes.