Medication Education... built into the EMR?

[Ewbok123]

Hi All,

My hospital hasn't been doing so great on the HCAHPS surveys asking patients about how often the nurses are educating on medications/ side effects/ etc. I recently joined a committee to try and come up with ways to increase our effectiveness and education.

One of the things we thought would be most helpful would be to have medication info (Indication, Dose Range, Side Effects...) built right into the MAR after we scan the patient and the medication so all the nurses would have immediate access to the info upon administering each medication, and everyone would be using the same language.

Do any of you work in hospitals or facilities that have your Med Info integrated right into your EMR?

Any other tips on ways to facilitate med teaching for the nurses would be extremely helpful! (A busy 6 patient med pass is difficult enough... Always looking for ways to improve!)

[Myrtle1061RN, BSN]

That is a fabulous idea, it would really make the task easier, and as you mentioned, everyone would be using the same language. Our hospital is scoring low on medication education as well.

Now, if my facility would only upgrade to EMR.

[Boog'sCRRN246, RN]

The EMR at my facility has this. It's not built in to the MAR, but there is a drop down box that links to our med education software and takes less than 30 seconds to access. The software has separate tabs for 'healthcare professional' and 'patient education'. We can then read off the information to the patient or print a copy for them.

[SHGR, MSN, RN, CNS]

If you have an EMR, there is no reason not to have education built right in. Making it part of the scanning process is brilliant- just, like a pop-up, or easily printable, or what were you thinking?

Is there a way to make plain-language discharge med teaching too? Ours is so terrible, not written in lay language at all.

[mmc51264, BSN, MSN, RN]

We have EPIC and there is a direct link to Lexi-Comp drug reference. If there is a drug that I don't know, I look it up. I can look any drug up in the room and explain to pt. I can also google anything from the room computers if I have to AND I have Medscape on my phone. We also can attach any medication, condition, or procedure to the After Visit Summary (AVS) when we print d/c instructions

[MunoRN, RN]

In most cases it's not a lack of access to educational material that causes low scores on the med education question on HCAHPS.

More than anything else it's a time issue. A nurse who has 2 hours to pass meds that based on what's required to pass them safely has 3 hours worth of meds to pass in only 2 hours, adding what could easily be an hour of education on new meds defies the laws of time as we know them.

The other factor is alerting staff to new medications for the patient and an ongoing tracking of the progress of education for that med. We flag the first dose of a new med for a patient, if the nurse confirms the initial education was done then the next two doses are also flagged for follow up education, evaluation of learning (teach back). If the nurse is unable to complete the the initial teaching with the first dose then the flag carries over to the next dose. If the staff have not confirmed initial teaching and follow up teaching and the patient is in the discharge process then another flag pops up saying the patient needs education to be completed prior to discharge.

[HouTx, BSN, MSN, EdD]

We have pt education info via (EBSCO) Nursing Reference Center. The materials are available in low reading level with lots of pictures and graphics... and multi-lingual. It's connected into our EMR to produce discharge instructions & link them to the patient's medical record. It's very important, from a clinical risk management perspective, to only use 'approved' materials for patient education.

I like NRC because it's the front end of CINAHL. Continually updated and evidence-based all the way.

[evastone, BSN, RN]

I work in a hospital with an EMAR. There is expert advice button that allows you to get a clearer picture of what you are giving your patients. In addition to explaining how the medications work in a way that can be imparted to the patients it also can give an indication of any actions you may need to take before giving the medication (if vitals need to be taken based on what it's for). Contrary to the nurse who commented that there isn't enough time to educate and give meds, I have usually found time to explain what I'm giving even on the worst nights. People aren't asking you to give them a course on each individual medication. A brief explanation on what they are for usually suffices. And Patients Notice!

[la_chica_suerte85, BSN, RN]

I'm surprised this isn't already in your EMR set up. One place I worked at, when we went to scan a med in the MAR, a link for the LexiComp reference would come up (this in itself was a bit of a bear based on the facility that used it as it would give perhaps a little bit WAY TOO MUCH info and it would take forever to scroll all the way down for the pertinent geographic region's information). Another had Lippincott references for not just meds but also for skills available in the EMR. If a nurse came upon a medication she hadn't seen before, she would look it up and let the patient know what it was before giving it. Pretty nifty. :)