Technology is increasingly being used at the patient bedside to improve patient safety and streamline nurses’ workload. Nurses represent the greatest number of direct healthcare providers and are recognized as the “last line of defense” in preventing medication errors in healthcare settings. Currently, a majority of healthcare settings have implemented electronic medication administration record (eMAR) systems using barcode medication administration (BCMA). While nursing students may be introduced to eMAR technology during clinical experiences, many report feeling unprepared to use these systems safely and proficiently (Weeks, Clochesy, Hutton, & Moseley, 2013). Preparing student nurses to use eMAR and BCMA technology prior to engaging in off campus clinical rotations will increase their familiarity with the electronic barcode medication administration process upon entering practice.
Significance
Safe and accurate medication administration is a major concern in health care today (Harris, Pittiglio, Newton, & Moore, 2014). Pre-licensure nursing students are expected to provide safe care to a group of clients, including medication administration and prioritization of nursing care and skills (Aggar & Dawson, 2014). Medication administration constitutes part of the education of undergraduate nursing students, and the aim of undergraduate preparation is for students to gain an understanding of medications and how to safely administer them (Sulosaari, Kajander, Hupli, Huupponen, & Leino-Kilpi, 2012; Schneidereith, 2014). The American Association of Colleges of Nursing (AACN) recognizes as students become more experienced, increasingly complex clinical learning opportunities should be selected to prepare students for entry-level practice (2008). This can be accomplished by providing students opportunities to assimilate to the registered nurse role, including multiple patient medication administration, with multiple patient assignments in the clinical setting as well as in the simulation laboratory.
Justification of the Study
Nursing students are typically introduced to eMAR/BCMA technology during off campus clinical experiences. Unfortunately, each clinical site may use a different type of eMAR, potentially creating confusion and frustration as students are faced with a medication administration learning curve each time they enter a different facility. Utilizing eMAR/BCMA technology for on campus clinical experiences and simulations may benefit students in multiple ways. First, students can be exposed to eMAR/BCMA technology earlier in the curriculum. Next, students can become proficient with medication administration using one type of eMAR/BCMA system prior to starting off campus clinical experiences. This would provide students with more opportunities to safely administer medications using advanced technology. Lastly, adding this technology to simulation will increase the “real-ness” of medication administration during simulated clinical experiences. To date, little research has explored the use of technology and simulation to help undergraduate students improve their multiple patient medication administration skills.
Purpose
This poster presentation outlines the process of implementing and evaluating the use of an eMAR/BMCA system for use with senior students engaging in multiple patient medication administration.
Methods/Evaluation
Senior nursing students in a nursing management course that focuses on care of multiple patients will individually complete a faculty-developed multiple patient medication simulation using an electronic barcoding system and an eMAR; once at the beginning of the semester and once again at the end of the semester. Students will be evaluated on their ability to prioritize medications, correctly administer medications to simulated patients, and their use of critical reasoning skills using a faculty-developed rubric after each simulated experience. Additionally, students' self-efficacy with multiple patient medication administration will be assessed by completion of the General Self-Efficacy (GSE) scale after each individual simulation. Students’ mean scores will be compared to determine the impact of eMAR/BMCA technology on undergraduate students’ self-efficacy and critical reasoning skills in administering medications to multiple patients in a simulated environment. Last, students will complete a narrative self-reflection describing how the multiple patient medication administration simulations with barcode technology helped to prepare them for clinical experiences with multiple patients.
Implications for Practice
Little research has explored how undergraduate nursing students prepare for and critically reason though multiple patient medication administration. Using technology to simulate multiple patient medication administration may help senior nursing students prepare for multiple patient medication administration as well assisting them to assimilate into the role of the registered nurse. The results of this study may also assist nurse educators in developing multiple patient medication administration simulation scenarios using technology.