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What is eMAR?

You may be wondering: what is eMAR? An eMAR system is used by nurses in hospitals and long term care facilities to ensure that medication is administered accurately and reliably. An eMAR can be installed in work computers or hand-held devices, such as smartphones and tablets, and it allows nurses to access patient records easily, thus improving the accuracy of nursing documentation.  The CMS website lists certification and standards criteria for using eMAR. These pertain to ensuring that the user verifies the patient, dose, route, time, date, and medication before administering medication using an eMAR.

eMAR Medical Abbreviation

You may be asking yourself: what does eMAR stand for? The eMAR medical abbreviation stands for Electronic Medication Administration Records. It is a term that is used in both acute and post-acute care. Its usability and the challenges involved in implementing it have been topics of research in recent years.

What Does eMAR Do? Ensure Timely Treatments and Medication Administration

eCharting is part of the integrated NetSolutions Electronic Medication Management system that includes ePrescribing, Clinical Decision Support, and Physician Orders. With eCharting, new orders and updates are available to the eMAR/eTAR in real time – ready for the next session. New orders are color-coded. Drug Information, Clinical Teaching, and Black Box Warnings are available when NetSolutions Clinical Decision Support software is installed. eMAR/eTAR replaces end-of-month recaps and paper versions of the MAR and TAR (Medication/Treatment Administration Record).

Our eMAR / eTAR Provides Paperless Point-of-Service Documentation

NetSolutions™ eCharting brings Long-Term and Post-Acute Care providers a point-of-service method of documenting care. It includes an eMAR and eTAR to improve accuracy and efficiency in charting medications, treatments, and vitals while making the information instantly available to residents’ Electronic Medical Records (EMR).

Point-of-Service Documentation

Long term care nurse using eMAR on a tablet.
eMAR can be used on a tablet or other portable device.

Connect to NetSolutions eCharting on the medication cart, at the bedside, in the dining room, or anywhere it’s needed when you use a portable device with a wireless connection to your facility’s network. Charting information is available to the network in real-time.

Point-of-Service data can be secured through software passwords as well as hardware devices such as biometric thumbprints and card scanners. Authorized physicians and staff can check on a resident’s status anytime, anywhere.

How Does eMAR/eTAR Work?

  1. The first step in preparing for a medication session is to build a list of residents using these criteria: location, shift, pass time, and route(s)of administration. eCharting reads the data from NetSolutions Physician Orders and assembles resident orders that meet the criteria. It gives you the option of further sorting by name, location, or odd/even rooms.
  2. Next, an eCharting page for the first resident in the session is displayed, showing the orders including PRN orders if selected (sample on page 4). Boxes are color-coded to highlight orders that are late, new (color-coded for the first 72 hours), due during this session, due in an upcoming session and held.
  3. As the session begins, simply click the Yes box for each medication/treatment administered and the box turns white. If an order is held, check No and document the reason. For orders flagged to require a vitals check or documentation, the system displays the appropriate window.
  4. If you notice that a medication supply is low, click the Reorder button to add your request to the order processing system using our ePrescribing functionality.
  5. After a resident’s medication/treatment pass is complete, click for the Next/Previous resident or a specific resident in the group. You can use barcoding to navigate to another resident. The system alerts you to any orders missed for the previous resident.
  6. When the session is complete, the system displays a summary page with statistics for the session including start, end, and elapsed time; PRN orders; totals for residents, delivered medications and treatments; plus any held, late, or missed orders. Drill down on each statistic for a list of residents, treatments, and medications.

Advantages of eMAR / eTAR

Notes Shared with the EMR

You can flag any order to require documentation at the time of delivery. Charting may also be required for orders that are late, missed, held, or PRN. Those notes are shared with NetSolutions Interdisciplinary Progress Notes with an appropriate category and become part of the resident’s electronic medical record.

Orders Updated in Real-Time

New orders and updates are available to the eMAR/eTAR in real-time. New orders are color-coded for the first 72 hours. Drug interaction warnings are available when NetSolutions Clinical Decision Support software is installed.

Handles PRN Orders

You have the option of displaying PRN orders on the session page. If none are needed, you do nothing. A history of past PRN administrations is at hand. When a PRN order is delivered, the system prompts for required documentation. After a session is complete, a PRN Results window is available in NetSolutions Physician Orders for documenting the outcome of PRN medications delivered. A summary of previous PRN administrations is in the same window.

Vitals Charting Connected to Orders

Orders may be flagged to require a specific vitals check of weight, temperature, pulse, respiration, blood pressure, oxygen saturation, and/or blood glucose. The results and any text notes are automatically shared with the Vital Parameters area and with Progress Notes, in a note associated with the specific order delivery.

Lab and X-Ray Orders

eCharting includes orders for lab and x-rays in session lists per the orders entered in Physician Orders. In an eMAR session, staff can be reminded to prepare the resident for the test or x-ray and chart their actions. Results can be recorded, similarly to charting PRN results.

Barcoding Identification

In addition to the photo on the eMAR page, you can verify a resident’s identity by using barcoding technology to scan a resident’s barcode, for example on a bracelet.

Complete Information at a Glance

Resident information always appears at the top of eCharting orders pages, including date of birth, gender, physician, allergies, advance directive, and any nursing alert. A list of diagnoses is a click away. Information Orders, such as “crush medications” are available in a dropdown list. Medications can be shown as “Pulled” to assist if the nurse is interrupted during the pass.

Dashboard for Key Performance Indicators

The built-in NetSolutions Dashboard puts key performance indicators at your fingertips with drill-downs for details. Check the Dashboard for KPIs such as the number of New Admits, Readmissions, PRN Waiting Results, and Held Orders – Past 72 Hours. Click for a list of residents who meet the criteria, along with actionable data.

Additional Features

  • Quick links for easier navigation to eCharting Session based on prior saved criteria
  • Eliminates end-of-month recaps by keeping orders current online
  • Supports the option to require two signatures at medication pass
  • Provides a one-step procedure for holding all medications for a resident. Requires charting of held orders for the EMR
  • Displays drug information, Clinical Teaching, and Black Box Warnings when NetSolutions Clinical Decision Support software is installed
  • Supports flagging a medication/treatment order to require a specific vitals check
  • Alerts automatically about missed orders
  • Connects the eMAR with Physician Orders and ePrescribing for medication reorder requests
  • New orders, including PRN, are displayed in blue in the eMAR for the first 72 hours
  • Reads barcoding to navigate to resident data and to identify residents and to improve resident safety
  • Displays informational physician orders, such as crush medications, on eMAR
  • Identifies medications/treatments delivered late, according to administration times you set up. Reports may be prepared on late orders
  • Links an electronic photo to an order to illustrate a resident’s condition, such as a wound, rash, pressure ulcer. Photos are available during the session, including date and descriptive text
  • Displays Nursing Alert text on the eMAR page with orders due to be administered
  • Provides an automatic date stamp and identifies the caregiver for each order delivered
  • Time values for delivering medications/treatments can be shown as a specific time, shift, or range such as early AM Orders can be shown as Stat and one-time
  • A resident’s history of order administration is available from the eMAR
  • Prepares a summary page automatically with data on medications and treatments administered in a session. Each statistic is hyperlinked to lists of residents, medications, and treatments, included in each category

On-Demand Reports

  • eMAR and eTAR: The completed Medication and Treatment reports show vital parameters and initials of staff who administered the medication/treatment
  • Late Orders: Orders that have not been documented
  • PRN Results: List of PRN orders delivered with documentation of the outcomes
  • Upcoming Meds/Treatments: Residents with orders due in an upcoming time period, shift, or pass
  • Corrections Report: List of notes correcting charting information, showing date, time, and caregiver
  • Descriptive Text Results: Notes entered for vitals, held meds, and other documentation
  • Resident Barcodes: List of residents’ HR number barcodes so you can scan a barcode to bring up their eCharting page
  • Session: Summary and detail reports showing order totals in several categories
  • Transaction Report: Generates an unlimited number of report combinations, such as how many PRN Acetaminophen was administered in a day, residents who received specific medications, and orders administered late. You can save your criteria to re-run a report

System Requirements

The implementation of an eMAR, point-of-care system requires:

  • NetSolutions eCharting, Physician Orders, and the full NDC library
  • Wireless network in the facility
  • Portable PC for each medication cart, such as a laptop, netbook, notebook or tablet
  • Medication carts that accommodate PCs, external batteries, and power access for recharging
  • For security and convenience, PCs with a biometric identification or card-swipe capability are required