Foundations of EBP eMAR Paper
Foundations of EBP eMAR Paper

Identify a project from a department at your place of employment that demonstrates a commitment to an improvement in patient care. (A project – introduction of eMAR, electronic medical record)
Why is this project/study important?
What role would an APN play in this project?
Identify a PICOT question that you could use to guide the research of the identified problem.
Provide 5 databases that you might use for your research, and give a short description of each.
What barriers do you foresee in implementing this project?

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The purpose of this paper is to get students thinking about what EBP is and how they would go about identifying and implementing a project.  The directions state:   4 pages in length, not including the title and reference page. (points will be deducted for papers over or under required length)
references on the project topic should be < 5 years old Foundations of EBP eMAR Paper. Foundations of EBP Paper Foundations of EBP Paper RUBRIC Ratings Pts This criterion is linked to a Learning Outcome Project Identification Clearly identifies a project or study demonstrating a commitment to improvement in care. Department, key players, goals are identified. 3.0 pts This criterion is linked to a Learning Outcome Identifies Importance of Project/Study The purpose of the project/study is clearly identified Foundations of EBP eMAR Paper 2.0 pts This criterion is linked to a Learning Outcome Evaluates the role of the APN in this project
All key elements are present: the role of the APN specific to this project. How does the scope of practice, standards of care, social, legal and economic factors influence the research project or study?

5.0 pts

This criterion is linked to a Learning Outcome PICOT Question r/t the project/Study
All key elements of a PICOT question are present:

P- Patient, problem or population

I – Intervention

C – Comparison

O – Outcome

T- Time

5.0 pts

This criterion is linked to a Learning Outcome Identifies Databases
Identifies 5 appropriate databases available for research with a short description of each

3.0 pts

Foundations of EBP eMAR Paper

This criterion is linked to a Learning Outcome Identifies Barriers to Implementation
All key elements are present

2.0 pts

This criterion is linked to a Learning Outcome APA Format
Paper is the required length and consistently documented in APA format

1.0 pts

Introduction of eMAR, electronic medical record
Electronic health records have been adopted in the healthcare system for about decade now. Their development sought to improve the quality and safety of the patients through efficient paperless record keeping. Electronic medication administration records (eMAR) describe the server-based electronic medication administration system designed to replace the paper form of medical recording. eMAR is useful in rehabilitation facilities, long-term care, assisted living and institutional pharmacies. Its main roles include automating the medical tracking, distribution and re-ordering process as well as safe treatment (Vicente et al., 2017) Foundations of EBP eMAR Paper. It also saves time and labor force as well as reduces medical errors that might otherwise undermine the safety of the patient. This paper describes a project on the introduction of eMAR, its importance, the APN related roles and a PICOT question that guides the research as well as the relevant databases employed in this research. Consequently, the paper presets the foreseen barriers to the implementation of the project.
Importance
Poor record keeping has resulted in the increase of healthcare cost over the years due to the occurrence of errors, cumbersome storage of medical records and job burnout among other factors. However, the introduction of Health Information Technology for Economic and Clinical Health (HITECH) Act ten years ago has seen notable adoption of multiple technologies in the healthcare sector. For instance, eMAR introduction has brought about a revolution in patient care with its rapid replacement of the paper medical administration recording. This has helped in saving time, labor, increasing efficiency and reduction of errors as well as maintenance of confidentiality. Moreover, the introduction of the technology is crucial in maintaining a seamless flow of information via integrated systems that decrease the possibilities of medical errors, duplication of data entry and also saves time in the healthcare facility (Seibert et al., 2014). Therefore, it also increases safety of the patient and the quality of healthcare provided Foundations of EBP eMAR Paper.
Role of the APN
Advanced practice nurse play notable roles in the introduction of organizational change. The professional practice of APNs is derived from a reflective experience characterized by a wide range of nursing skills and knowledge. They are involved in the admission of patients, prescription of drugs as well as referrals. Considering that the electronic medical administration records are designed to improve the safety of the patient in these areas, the APN will be actively engaged in the change process. Their roles will include interdisciplinary collaboration geared towards ensuring the effectiveness of the project in increasing the safety of the patients. This will involve advisory and consultative services that will promote evidence-based practice and use of the new technology (ED Management, 2018) Foundations of EBP eMAR Paper. Moreover, APNs will be involved in planning, implementing and evaluating the health programs involved in the eMAR systems to ensure efficiency.
PICOT questions helps in finding the best available evidence to influence the nursing practice. PICOT stands for P-Patient/Problem, I-Intervention, C-comparison, O-Outcome and T-Time. The problem demanding the organizational change is the increase in healthcare cost for patient due to lack of a standardized and efficient medical administration recording system. The intervention addressed by the project is the introduction of eMAR system in the healthcare organization. Consequently, the project is comparing the intervention with the paper electronic medical administration records on the comparison section of the question. On the other hand, the anticipated outcome of the project is the increased efficiency with regard to safety and healthcare cost reduction for a period of six months through which the project is expected to run. Therefore, the PICOT question guiding the research study is, “Does the introduction of the electronic medical administration records increase the efficiency and safety of the patients within six months?” Foundations of EBP eMAR Paper.
Databases and Description
Elsevier Science Direct provides a wide range of access to medical research materials. The database is a subscription-based website containing four categories of journals namely the health sciences, life sciences, engineering and physical sciences. It provides multiple e-books, academic journals which exceed 12 million pieces (Friedlander & Khan, 2016) Foundations of EBP eMAR Paper. The articles present are interdisciplinary, high quality and help find answers to research questions in wide range of areas including my project on the introduction of the electronic medical administration records. I was able to research on patient’s safety in the automation era.
Another database used in this research is the Cochrane Library-Wiley online library. This database provides independent, high quality collection of healthcare evidence that informs decision-making and helps answer various research questions. The collection of databases is published by Wiley and hosts material science, health science and peer reviewed journals and is accessed through subscription. The database provided articles on the effects of eMAR application on the safety of the patients.
Notably, CINAHL is the most in-depth and largest database for nursing research. It refers to the Cumulative Index of Nursing and Allied Health Literature and is effective particularly in qualitative research studies. It covers all fields of nursing including the electronic medical record area which makes it relevant for this project. Further research was conducted in the MEDLINE via PubMed database. This site contains online books, science journals, citations and other literature material for life sciences and biomedical subjects through the free search engine access, PubMed. This site was effective in understanding the organizational and quality changes brought about by the project introduction. Lastly, I used the ERIC database. This is the Education Resources Information Center that provides full-text and indexed education literature material on the online digital library. It is run by the U.S. National Library of Education (NLE) and contains documents, synopsis, reports, books, studies, tests and pamphlets relevant in multiple study fields including healthcare (Friedlander & Khan, 2016). This site was crucial in providing an overview of the eMAR system Foundations of EBP eMAR Paper.
Barriers to Implementation
The implementation of the eMAR is challenged by several barriers including the hospital culture (ED Management, 2018) Foundations of EBP eMAR Paper. The hospital staff is used to the use of paper medical administration recording which might affect the implementation of the electronic system. The change in the organization culture might cause stress and low productivity as well as resistance from workers. According to Relias Media (2019), poor usability of EMR results in concerns of staff burnout as well as patient safety concerns. This is evident in the increased number of medical errors discovered in various health organization departments that placed the patients’ lives at risk.
The privacy concerns may also act as barriers to the implementation of the project. This is because, the confidentiality of the sensitive medical records is legally demanded and thus, cyberattacks such involving data mining and hacking can undermine the privacy and security of the patients information (Aldosari, 2017). The cost of purchase, training, hiring and installation of electronic medical health record is also high which could limit the implementation of the electronic medical administration records Foundations of EBP eMAR Paper.
References
Aldosari, B. (2017). Patients’ safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked, 9, 230-233.
ED Management. (2018). Hospitals Leverage Safety Huddle to Reduce Patient Harm, Boost Transparency, and Drive Culture Change.
Friedlander, R. R., & Khan, A. M. (2016). U.S. Patent No. 9,230,060. Washington, DC: U.S. Patent and Trademark Office.
Relias Media. (2019). Poor EMR Usability Linked to Patient Safety Concerns, Clinician Burnout. Retrieved from www.reliasmedia.com/articles/144399-poor-emr-usability-linked-to-patient-safety-concerns-clinicianburnout on September 11,2019
Seibert, H. H., Maddox, R. R., Flynn, E. A., & Williams, C. K. (2014). Effect of barcode technology with electronic medication administration record on medication accuracy rates. American Journal of Health-System Pharmacy, 71(3), 209-218.
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 Foundations of EBP eMAR Paper.