1. Adams, Jeffrey M. MSN, RN
  2. Williams, Virginia I. MSN, RN
  3. Schirmer, Leslie BSN, RNC
  4. ADAMS, Alicemary Aspell MBA, BSN, RN

Article Content

Background: The current state of technology adoption related to patient safety and clinical organizational efficiencies include strategies for point-of-care (POC) documentation, bedside medication verification (BMV), and electronic medication administration record (eMAR). These solutions have been well studied, and all have been identified as key factors in reducing errors.1,2 Particularly BMV and eMAR are designed to assist with alerts, notifications, and documentation related to medication delivery, and they are currently being deployed in hospitals throughout the United States.


Process: This presentation provides a comprehensive and detailed review of the patient care environments within two U.S. acute care institutions/systems preparing for POC, BMV, and eMAR. This review aimed to understand clinical informatics documentation device types (personal digital assistants [PDAs], laptops, tablet PCs, stationary PCs, and/or workstations on wheels) required to provide the safest and most efficient care delivery in organizations embracing POC documentation. The review, completed throughout each care delivery area within each organization, included assessment of current device use as well as new device needs anticipated with the adoption of POC, BMV, and/or EMAR.


Each patient care area was assessed by a survey team for consideration of workflow and any specific physical space, wireless connectivity, and/or power limitations that could dictate the type of computing device that could be used. Previous budgetary counts of devices and other data were validated or changed given any new discoveries. Metrics describing each patient unit were captured to provide understanding of the care provider environment and to provide the team with the ability to analyze similar care units.


Outcomes: The assessment data gathered were placed into a costing tool for evaluation. Metrics for device selection were developed to limit subjectivity in selection. Given the somewhat fragile nature of the computing equipment, strategies including spare devices, warranties, and policies to maintain infection control were included in the criteria for device selection. The project teams within the two organizations highlighted in the presentation were both greeted with great enthusiasm by the organizations' boards of directors and executive teams for formalizing and structuring the device selection process and for identifying the need for care delivery, maintenance, and operational process improvements.




1. Langowski C. The times they are a changing: effects of online nursing documentation systems. Qual Manage Health Care. 2005;14(2):121-125. [Context Link]


2. Poissant L, Pereira J, Tamblyn R, Kawasumi Y. The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. J Am Med Informatics Assoc 2005;12(5):505-516. [Context Link]