Optimization of Simulated Electronic Medication Administration for Safe Management During Nursing Education
Abstract
Background: Academic institutions have begun to implement electronic medication administration record (eMAR) technologies into simulated education for undergraduate nursing students. As these technologies are adopted, there is an increasing need to develop insights toward optimal medication administration practices, including the decision-making processes undertaken by nursing students.
Research Question: How do nursing students generate optimized medication administration processes using eMAR technology in simulated clinical practice?
Method: This study is underpinned by the theoretical lens of interdependent, cooperative Game Theory. Primary data collection was conducted using direct participant observation of nursing students administering medications using a simulated eMAR system and a semi-structured interview following the observation. The participants reacted to different scenarios that challenged the College of Nurses of Ontario’s medication administration heuristic of Clear, Complete, and Appropriate. Findings were individually and collectively summarized, including detailed descriptions of the participants’ actions and decision-making processes, visualized on Game Theory-informed payoff matrices.
Findings: A number of different findings were uncovered in this study. The repeated occurrence of a no relationship interaction between the student and eMAR; the inappropriate use of the Medication Rights heuristic during the administration process; and, the inherent trust in the eMAR system to be correct or assist in situations of uncertainty.
Conclusion: New insights into the complex relationships created between nursing students and an eMAR system have been explored. The dynamic relationship between eMAR administration best practice principles and process efficiency warrants further examination.