Refactor eMAR to address compliance and dangerous situations.

Hi,

The eMAR system as it stands breaches compliance and can easily lead to a dangerous medication overdose situation.

Firstly the breach is that the entries on the eMAR are able to be changed or overwritten after they have been recorded. This would be seen by CQC as a falsification of a legal document and any company caught doing this could be had up for professional misconduct.

The way a paper MAR works is once a entry is made is cannot be altered and any errors are recorded on the back on the page dated and signed. This is also used for auditing and quality control purposes.

To correct this in your system would be relatively easy.. Simply make it that entries can be created but not edited then create a method of recording notes that relate specifically to a particular weeks eMAR (entered on and shown on the MAR page when looking at the week in question).

We have already had a situation where a PREVIOUS carer on a PREVIOUS visit logged that Paracetamol was "refused". When the NEXT carer attended Paracetamol was taken and when the carer recorded it the "refused" record was overwritten so we had no record of the medication refusal which leads me onto the second issue..

The second issue is not so easy to solve and would require some refactoring of the eMAR.. It would be far more functional to have a time stamped log of medication records for a day rather than just Breakfast, Lunch, Dinner, Evening/Night. This would allow the display on the mobile to display all the times a medication was administered previously that day so there is little chance of an overdose situation..

For example the mobile could display..

Paracetamol

29/09

07:11 - Administered [AB]

12:18 - Refused [CD]

14:07 - Administered [EF]

In the example the carer can see the time between doses and would know that Paracetamol requires a 4h interval so would know it was safe to administer at the 2pm visit because they could see it was refused at 12:18.. Had the medication been administered at the 12pm visit they would not be able to administer at 2pm even if the SU requested it for pain.. Currently the carer can see no details of previous eMAR entries for the day, they can see a whole week at the current time which is not useful or relevant..

Also with the current system if an SU requires a medication more than 4 times a day the eMAR won't record all the entries and will at some point overwrite previous entries meaning the record is inaccurate..

Sorry for the length.. I am happy to discuss anything that is not clear..

Thanks,

Harley