Orders: eMAR

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Introduction to eMAR

The eMAR (electronic medication administration record) page allows you to view the current medications that are due for a patient, and document medication administration. NOTE: Unverified medication orders (UV) are not available in the eMAR. This means that Discharged (DSCH) orders will not be displayed in the Scheduled tab of eMAR if the order status is unverified (UV), even when the Show inactive orders check box is selected.

For non-formulary medications to appear on the Orders Tracking and eMAR pages, the user must have permissions granted for Home Medications. This setting in defined in the User Administration module. (Go to UA and select the appropriate user. Then, from the OM User Department Permissions tab, check the Home Medications department and select the appropriate permissions.)

To access the eMAR, use one of the following methods:

(Preferred method) From the Hospital main page, use the Select button to select the appropriate patient. Then, click the eMAR button. The eMAR: Scheduled page is displayed with the selected patient information displayed in the yellow bar at the top of the screen.

Click the eMAR button on the Hospital main page. The Patient Visit Search box is displayed. Begin typing the patient's information (last name, SSN#, or D.O.B) in the blank field. See Selecting Patients for additional information about using this feature. Once the patient has been selected, the eMAR: Scheduled page is displayed.

Medications are divided into the following tabs on the eMAR:

Scheduled tab	The Scheduled tab displays individual scheduled doses of medication in the order that they are due to be administered. See eMAR Scheduled Tab.
PRN tab	The PRN tab displays those medication orders prescribed on an as-needed basis. See eMAR PRN Tab.
Continuous IV tab	The Continuous IV tab displays orders for large volume IV fluids that are prescribed to run continuously. Non-Continuous IV and Non-IV orders are administered from either the Scheduled or PRN tabs. See eMAR Continuous IV Tab.
All tab	The All tab allows you to view a summary of medications scheduled or administered for a patient. You can also access a detailed view of the order, administration, instructions, interaction checking results, and monograph. See eMAR All Tab.
IV Site Tab	The IV site tab displays a list of IV sites. See IV Site for details on adding, editing, and viewing IV site information.

Symbols used on all tabs of the eMAR

Each medication shows the brand and generic name, strength, dosage, frequency, route, rate, date/time last given, and status. The following icons and function buttons allow you to view additional information as it applies to each medication. Function buttons are displayed to the right of each medication.

	Indicates a home medication; displays to the left of the medication.
	Indicates a prep is indicated. Prep information is viewable on the Order Detail tab of the Administration fly over and when clicking the Show Details button on the All tab.
	Witness Pending: This icon indicates that a medication order is still awaiting a witness signature. To sign the order (as the witness), go to the Administration Details and enter the appropriate credentials.
	Conflict button: Click this button to view conflicts.
	Administration Details button: Once the medication has been administered, click this button to view and/or edit the administration details. See Working with administration details and To edit administration details for more information.
	Order Details button. Click to access order details including patient demographics, department order information, and medication order information.
	Monograph button: Displays a medication monograph containing information about usage, directions, and side effects.
	Indicates the solution has an additive; displays to the left of the medication.
Use Home Supply	When this text is displayed under a medication, it means that the patient has brought a medication supply from home and that supply should be used to medicate the patient. This indicator is identified during the order entry process. See CPOE for details.
	UpToDate™: If your facility utilizes the UpToDate™ functionality (3rd party clinical decision support database), you may see this icon next to an order or order set. This icon indicates that there is evidence and research available in the database to support an action, e.g. order, diagnosis, medication, etc. Click this icon when you see it to launch the UpToDate™ portal and view the supporting documentation and research. The use of the UpToDate™ database requires licensing and setup. Contact your Account Manager for details. See Also: UpToDate.

Statuses used in eMAR

For medications displayed on the tabs of the eMAR, the status column displays a code that identifies where in the process of being completed that the order stands. Use the following table to identify the status of the medication order:

The color codes in the table above indicate how the order is highlighted in the Pharmacy application. On the eMAR pages in the Status column, if a medication order has been verified by a pharmacist, the status will be a bold, green letter E. If the medication order has not yet been verified by the pharmacist, the status code, i.e. UV, DC, CA, will be bold and red in color. The Status column appears on all eMAR tabs: PRN, Schedule, and Continuous IV.

To view/print MAR Reports

MAR Reports are available by going to Reports > Visit Reports. Next to the Medication Administration Record option, click the Show Print Details button to display the Report Parameters section. Enter the appropriate criteria (date range, etc.) and click Generate Report. The report is displayed in a new tab where you can print the report, if desired. The MAR has 3 options for generating the report:

Print Administration Records: This option displays all of the administrations that were documented in the eMAR and leaves a blank space when the medication was not been documented in the eMAR. Click here for sample. [+]

Print Blank Administration: This option prints the medication names and administration times, but leaves space for users to manually sign off when administrations are given. This report can be used as a "downtime" report when the user is unable to administer the medications in the eMAR. An "N/A" is displayed in date/time slots where medications are not to be administered. Click here for sample. [+]
Print Blank Report: This option generates a completely blank report in which the user can write the name of the medication(s) and times. Click here for sample. [+]

BCMA (Bar-Coded Medication Administration)

BCMA provides a method for documenting medication administration using barcodes. This process helps reduce medication errors by ensuring the right patient, right medication, and right time.

The use of the BCMA requires licensing and setup. Contact your Account Manager for details.

To access BCMA, go to the eMAR page and click the BCMA button in the top right corner. The BCMA prompt is displayed. This prompt is necessary for you to begin scanning.

At the Scan Visit prompt, begin by scanning the patient wristband. Then, click Confirm. The Scan Medication prompt is displayed.
In the Scan Barcode field, scan the medication label.
In the Scan Route field, scan the medication route. (The Route barcode can be printed from the Pharmacy > Master Files > Routes > Edit window.)
Click Confirm.

In the case that you are scanning a medication that is assigned a barcode that is also assigned to other medications, you will receive one the following messages:

There is more than one medication ordered for this patient with that barcode, Select the medication that you are administering. - Displayed when two orders for the patient have the same barcode. The message displays the two orders and the user must select the appropriate order.
There are other medications that use this same barcode, Make sure you have the correct medication. Is this the correct medication?" - Displayed when this order for the patient has the same barcode as other medications in the formulary. The user must select Yes or No.
There is more than one medication ordered for this patient with that barcode, Select the one you are administering. - Displayed if the patient has two ordered medications with the same barcode, but one order is inactive. The user selects the appropriate medication. If the inactive medication is selected, the message, This medication is inactive. It cannot be administered. is displayed.

In the case that you are scanning a PRN medication that is expired, you will receive the following message:

This medication is not scheduled for administration on the selected date. If the administration date entered is before the expiration date, the medication scan is accepted. If the date is after the expiration date, the message indicates that the administration date/time is after the order is expired. This allows you to chart a medication even if the charting is completed after the medication is stopped.

Otherwise, the Scan Medication Warning box is displayed. This box verifies the 5 rights of administering medications for the user by validating the following fields: Name, Strength, Dosage, Quantity, Route, and Time. Green check marks appear next to the validated items. Red circle with a line through it indicates that the field was not validated. In the Correct Value column, the correct value is displayed for reference. Messages regarding the results of the scan are displayed at the top of the box and may include the following:

Wrong Patient
Wrong Medication
Correct medication, wrong date/time
Correct Medication, wrong dose
Wrong Route
Failed scan

The Rescan Barcode field is displayed when the quantity of the ordered medication does not match the quantity of the scanned medication. The cursor defaults to the Rescan Barcode field. To increase the quantity, rescan the medication. If the order quantity matches on the rescan of medication, the administer box is displayed, so that the user can the barcode.
Click Ok, to continue with giving the medication. Or, Cancel to return to the Scan Med field.
The Administer medication details window is displayed. See Administering Scheduled and PRN Orders for details on using this window.

Notes re: Secondary Witness:

If a secondary witness is required, the following scenarios are possible:

- The secondary witness is in the room with the administering clinician and when the administration details box is displayed, the witness user enters their username/password (or scans name badge) and clicks Verify.

- The secondary witness is not in the room. The administering clinician uses the Bypass button to continue with the administration. By doing this, the medication becomes Pending/Waiting Signature on the Scheduled tab of the eMAR. The secondary witness must go to the Scheduled tab of the eMAR, display the administration details box, enter the secondary witness username/password (or scans name badge) and click Verify.

Click Administer to administer the medication and return to the eMAR page.

To view BCMA Reports

BCMA Reports are available by going to Reports > General Reports. Click the Show Print Details button to display the Report Parameters section. Enter the appropriate criteria (date range, etc.) and click Generate Report. The report is displayed in a new tab where you can print the report, if desired.