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e-MAR

Training
Manual

Offers real
time
at your

Copyright © 2010 MED e-Care Healthcare Solutions Inc.. All rights


reserved.
Copyright Information

© 2010 MED e-Care Healthcare Solutions Inc. All rights reserved. No part of this
document may be reproduced or transmitted in any form or by any means, electronic
or otherwise, including photocopying, reprinting or recording, for any purpose,
without the express written permission of MED e-Care Healthcare Solutions Inc

Disclaimer

Information in this document is subject to change without notice and should not be
construed as a commitment on the part of MED e-Care Healthcare Solutions Inc and
does not assume any responsibility or make any warranty against errors that may
appear in this document and disclaims any implied warranty of merchantability or
fitness for a particular purpose.
CONTENTS

Preface...........................................................6
About this Manual..................................................................................6
Audience................................................................................................6
Related Documents...............................................................................6
Document Conventions.........................................................................6
Support Information..............................................................................7

Introduction....................................................9
Product Features...................................................................................9

Getting Started..............................................12
Accessibility.........................................................................................12

e-ADT............................................................15
Information Post..................................................................................16
Admission/Discharge...........................................................................21
Transfer...............................................................................................35
Retirement..........................................................................................42
History.................................................................................................44
Resident Discharge History.................................................................47

e-MAR...........................................................54
MED e-care..........................................................................................54
MED / TAR Pass Status........................................................................55

Index Page | 3
Client Search Options..........................................................................56
Client Sort Options..............................................................................57
Administration & Information Update..................................................58
PRN Administration..............................................................................61
Administration Notes...........................................................................63
BIO Tests.............................................................................................65
Manage Orders....................................................................................71
Manage Orders from the MED Pass Screen.........................................77
MAR Screen for Medications ON HOLD or DISCONTINUED..................83
Manage Follow Ups/Overdue/Test -- Hotlist.........................................85
Quick Reports......................................................................................89
Tracking of New Orders and Reorders.................................................90
Order – Add to MAR Now.....................................................................91
Order – MAR/TAR Notes.......................................................................97
Physician Order – Enter New Order.....................................................98
Order-Receive Orders........................................................................102
Order – Sign, Print, or Fax Physician Orders to the Pharmacy...........102
Order – Waste Dosage Management.................................................104
Order-Unsigned Orders.....................................................................105
Generate Previous Order Report.......................................................106
Leave of Absence - LOA.....................................................................107

e-MAR Reports.............................................112
Individual-Group Reports...................................................................112

Recommended e-MAR Procedures.................117


Glossary......................................................119
Index...........................................................120
Index

Index Page | 4
Version History

No. Version Prepared by Comments / Key changes


Date since last version
Ver1 Septemb M.Virender Conceptual Overview,
.0 er 18, TechTotal Information Design,
2008 Soft Systems Development of outline
Draf Pvt. Ltd content, Maintain Style
t

October Murali, Formatted and edited the


23, 2008 Jayashree document according to the
TechTotal template style
Soft
Systems
Pvt.Ltd
Novembe Nathaniel Revised and updated
r 6, 2008 Tenefrancia document (for v.1098.02)
Med e-care
Healthcare
Solutions
March Dale Yoon – Revised and updated
17, 2009 Mede-care document (v1098.14)
Sept 3, Dale Yoon – Revised and updated
2009 Mede-care document (v1098)
March Shravan and Revised and updated
25, 2010 Virender document
April 09, Shravan Revised and updated the
Updated Cynthia number

Index Page | 5
P
R
E
F
A
About
C this Manual
E
This manual describes the e-Care application and explains how to work and use its
major features. It serves as a means to describe the User interface and how to use it
to accomplish common tasks.

Audience
This user manual is addressed to Administrators and End Users of the MEDe-care
application.

Related Documents
All e-Care documents are available online in both printed (PDF) and online (HTML)
formats at the following link http://www.mede-
care.com/medecare/MedecareHelpPortal/MED%20e-care%20user.htm

Figure 1: Online Documents

Index Page | 6
Document Conventions
In this manual, certain words are represented in different fonts, typefaces, sizes, and
weights. This highlighting is systematic; different words are represented in the same
style to indicate their inclusion in a specific category.

Additionally, this document has different strategies to draw User attention to certain
pieces of information. In order of how critical the information is to your system, these
items are marked as a note, tip, important, caution, or warning. For example:

Icon Purpose

Note

Courier new Filenames, URL’s, Directories,


Font and paths

Important

Blue text Indicates links and cross


references

Black boldface User interface elements such


as button names and menu
items

Support Information
Every effort has been made to ensure the accuracy of the document. If you have
comments, questions, or ideas regarding the document contact our online support:
support@mede-care.com

HOW TO CONTACT SUPPORT CENTER

You can contact MED e-Care support center by:

Telephone:

 1-800-387-8903 (Toll Free, Canada and USA)

 0808-101-2783 (United Kingdom)

 416-686-8592

 Connect here if support is on the phone line

Index Page | 7
Chapter 1

Introduction to eMAR
This chapter will introduce you the purpose and
features of this application……

Index Page | 8
I 1
N
T
R
O
MED e-cares electronic MAR offers clients an innovative and integrated solution to
medication administration. The web-based application provides users with secure
D
and convenient access to client medication records; allowing for real-time recording,
collection, and reporting of patient data.
U
Product Features
C
TI
Increased Efficiency

O • Barcode technology provides nursing staff with instantaneous access to


patient and medication information
N
• The administration of medication and treatments are recorded in real-time
• Users have the ability to manage medication orders directly from the MAR
administration screen; medications can be discontinued, reordered, or placed
on hold during a MED Pass
• Waste dosage is automatically updated for the facility and notification is sent
to the pharmacy if replacement drugs are required
• e-MAR allows users to submit new physician orders online
Improved Drug Accuracy and Patient Safety

• All relevant patient information is conveniently displayed on the MAR


administration screen making it easier for nursing staff to verify the 5 Rights:
○ Right Drug
○ Right Client
○ Right Dose
○ Right Route
○ Right Time

Index Page | 9
• Patients medical conditions and allergies are listed with patient MARs and
TARs
• Nursing staff receive system reminders alerting them to time-sensitive
medication, treatments, and follow-ups
• e-MAR allows users to review or add documentation during or after
administration, which includes the ability to view and record bio-test results
and PRNs
• Users are given the tools to effectively manage emergency stock medication
and medical directives online
Secure System Access

• e-MAR is a web-based application that can be securely-accessed from any


location
• e-MARs wireless capabilities enables the software to be used on a mobile
device, such as a tablet computer
Convenient Access to Patient Data

e-MAR provides users with a number of individual and group e-reports, including:
• Medication Administration Record Sheet
• Physicians Three Month Review
• Pharmacy Medication Inventory
• Medication Administration List
• PRN List
• Associated Medication BIO Test
• Follow-up List
• Physician Medication Order
• Drug Record Book
• Drug Control
• Overdue
• Medication Summary

Index P a g e | 10
Index P a g e | 11
Chapter 2

Getting started
This chapter will introduce you to getting started
with the MED e-care application.........

Index P a g e | 12
Index P a g e | 13
G 2
E
T
TI
N
Accessibility
G
S
As the application is a web based application a unique URL is provided for the user.
Access the application with the URL. User needs to enter a valid user name, email ID
and password in the text fields provided .Click Sign-in button to log into the
T
application.

A
R
T
E
D

Figure 2: Login Screen

Following are the steps to login to the e-MAR application:


1. Registered users will get a unique user id and password from Med e-care
application
2. Users should connect to https://bcecareiv.mede-care.ca/ecareiv (for BC
users) or https://hosting3.mede-care.ca/ecareiv (for ON clients) URL
through the Internet Explorer
3. To log into the Med e-care application enter username (can just be first name),
email and password in the login page

Index P a g e | 14
If the Username and Password did not match then user cannot proceed for
further operations

The home page of the application appears, once when the user logins to the
application.

Figure 3: Home Page

Index P a g e | 15
Index P a g e | 16
Chapter 3

e-ADT
This chapter will introduce you to e-ADT
module........

Index P a g e | 17
E 3
-
A
D
T
Client Admission, Discharge, and Transfer information is stored in the e-ADT module.
Resident demographic information such as contact information, diagnoses, and
advance directives are collected and documented on MED e-care’s e-ADT system.

Following are the options available in e-ADT module:

1. Information Post

2. Admission/Discharge

3. Transfer

4. Retirement

5. History

Index P a g e | 18
Information Post
Bulletin

Figure 4: ADT HotList

• Search for the details using the Selection Filter

• Search By option provides a text field to enter the search criteria. By default,
system displays all the existing records.
• Click on the client Name, to view the client details.

Client Management
• Search for a resident using the alpha-menu or resident listing

Index P a g e | 19
Figure 5: Resident Listing

To view the resident details,

1. Click on resident name, a screen with resident information is displayed.

2. Edit the resident demographic information and click Save button.

Figure 6: Resident Demographic Information

To view the resident contact details or add new contacts, click Contacts tab as
shown below.

Index P a g e | 20
Figure 7: Contact Information

To Add New Contact, click

Figure 8: Adding New Contact Details

Enter the mandatory fields to Add new contact information and click Save button

Index P a g e | 21
• When Emergency Contact (Primary) is selected, the Emergency Contact
(Secondary) option is disabled.

• When user selects any one option from the POA-Personal Care (Secondary),
POA-Personal Care (Joint), POA-Personal Care (Joint and Several) and POA-
Personal Care (Primary), will disable the remaining checkboxes.

To Delete a Contact:

1. Select contact to be deleted


2. Click Delete button to remove the contact from the resident’s contact list

Figure 9: Resident contact list

Index P a g e | 22
Admission/Discharge

New Admission – Setting Up New Resident

Figure 10: New Admission

A new resident can be set-up through New Admission in e-ADT

1. Select Program of Care


2. Select a Client from the List and Click
OR

Click Admit New Client

If a new user is admitted, skip New Admission.

If the user is already admitted then system raises an error as shown below.

Index P a g e | 23
Client Identification:

Indicates that fields are mandatory

Figure 11: Client Identification

To admit or pre-admit the client,

1. Enter the Basic Information of the client such as Title, First Name, Middle
Name, Last Name, Jr/Sr. Alias, Gender, Birth Date, and Marital Status in
their respective fields.

2. Select the Health Card Information from the given list.

In the General Information section,

3. Select the Country of Residence from the drop down list.

4. Enter the Province/State, City in the respective fields.

Index P a g e | 24
5. Enter the Postal code of Prior, Residence, Street Name and Number,
Apt/Unit/Suite of the client in the given fields.

6. Select Primary Language, Religion from the drop down list.

7. Enter the Home Phone, Fax Number, Business Phone, Cell Phone in the
given fields.

8. Enter the Email address.

Resident Contacts:

Figure 12: Resident Contacts

1. Select the Funeral Home from the drop-down list provided


2. Click Show Details or add New Funeral Home to the list
OR

To add New Client Contact, click New Contact button

To view the details, click Show Details button. The funeral details are displayed as
shown below.

Index P a g e | 25
Figure 13: New funeral details

Click Save to save the details.

Client Health Status:

Enter pertinent resident information by clicking on the appropriate checkbox and


entering additional text in the field provided.
• Allergies
• Treatments
• Medications
Enter Diagnoses by clicking Add. In the corresponding window, select resident’s
diagnosis and click Ok when finished.

Index P a g e | 26
Figure 14: Client Health Status

Advanced Directives

Figure 15: Advance Directives

• Enter Client Advance Directives

Admission Information

Index P a g e | 27
Figure 16: Admission Information

In the Admission Information section,


1. Select a date from the Admission Date
2. Select the Admission Time
Note: Register Number is auto populated.
3. Select a Program, Admitting Physician, Primary Physician and Unit
Admitting to. from the drop down list
4. Select Lived Alone option.
5. Select Admitted from Facility/Level of Care and Admitted From Facility
Number from the drop down list.
Once all the information is entered, click Pre-Admit button
(Do Not Complete Signature Fields)

• Completed Signature field is Mandatory to Admit the Client


• General Information of the client is auto populated.

e-MAR alerts the user for any upcoming scheduled events for that resident

Index P a g e | 28
Figure 17: Confirmation message for Pre-Admission

Current Admission Information


Resident information can be modified through Current Admission

• Select a resident from the resident list or else select from Search By
Selection Filter or the alpha menu

Index P a g e | 29
Figure 18: Admission List

• Edit the information and click Update

Index P a g e | 30
Figure 19: Edit Information

• Once the Information is saved, e-MAR will alert the user for any upcoming
events

Re-Entry of Client to Facility

A resident returning to the facility (from the hospital) can be re-admitted with the
original profile in the system.

Index P a g e | 31
• To re-admit a resident, select Re-Entry record to view ex-residents
• Select resident by using the Search By filter or else click on the resident’s
name from the resident list

Figure 20: Re-Entry

• Enter the necessary information and allocate a bed to the client from search
icon provided
• Select Institution Level of Care and include Notes in the text box provided

Index P a g e | 32
Figure 21: Admission Facility

Figure 22: Bed Allotment

Signature is Mandatory.

Index P a g e | 33
Figure 23: Re-Enter Details

Click the Re-Entry button

If the signature is not performed, an error is displayed as shown below.

e-MAR schedules Re-Entry Tasks and allocates Bed to the Client and Schedules
Alerts

Index P a g e | 34
Figure 24: Status Details

Resident Discharge Information

When a Client leaves a Facility, Discharge Paperwork is required and system needs
to be documented. Client and Medication will be removed from Administration
Screen

Select a resident to discharge from the resident list or by using the Search By
selection filter

Figure 25: Discharge

Index P a g e | 35
• Update the discharge information

Figure 26: Update Discharge Information

Signature is Mandatory to discard a client.


e-MAR generates discharge, releases the beds and closes the resident episodes.

Figure 27: Discharge status information

Transfer

Transfer Information
Resident transfer information will update e-MAR to remove the resident and their
medication from the administration screen

Index P a g e | 36
Select Transfer from the left tab, to view the clients list.

Figure 28: Transfer

Select the resident to transfer

Index P a g e | 37
Figure 29: Register Transfer

To transfer the client,

Transfer Date and Transfer Time details are auto populated.

1. Select Estimated Re-Entry Date, Estimated R-Entry Time and Leave Of


Absence.
2. Check the Resident Aware, Next Of Kin Aware, Physician Is Aware and
Emergency Contact Aware options
3. Select the Institution Level of Care (if required) form the drop down menu
provided and include Notes for transfer
4. Select the Transfer to Facility Number from the search icon provided.
5. Enter comments (if necessary)

• By default Max Days On Hold Before Fees and Max Days On Hold Before
Discharge are disable. Check Set Bed Status to Hold to enable those
options.

• Signature is Mandatory

Index P a g e | 38
Figure 30: Institution Details

Internal Transfer of Client


The Internal Transfer of a resident option allows the client to transfer to a different
unit in the same facility

Index P a g e | 39
`

Figure 31: Client Internal Transfer

Select a resident to perform internal transfer, the following screen with transfer
details are displayed.

Figure 32: Internal Transfer

Index P a g e | 40
To transfer the client,

The Transfer Date and Transfer Time details are auto populated.

1. Check appropriate Resident Aware, Next Of Kin Aware, Physician Is


Aware and Emergency Contact Aware options.
2. Select the Resident and New Nursing Unit from the dropdown menu
provided
3. Select the New Bed from the search icon provided, the following screen is
displayed.

Figure 33: Bed allot ion

Select the available bed, to transfer the client. Incase if the occupied bed is
allotted an error “You must select a Bed that is available” is displayed.
4. Enter Notes (if necessary)
5. Click Transfer button, the information is update

Bed Swap
A resident Bed Swap can be easily updated through Bed Swap

Index P a g e | 41
Figure 34: Bed Swap

To swap the client bed,

The Bed Swap Date and Swap Time is auto populated.


1. Select the First Client information and Second Client information using
the browse option.

Figure 35: Client Information

2. Click Swap, e-MAR will update all client information with the change in Bed

Index P a g e | 42
Retirement

Apartment Management

Figure 36Apartment Management

To create a new apartment,

1. Enter the Floor number

2. Select Accommodation Type and Unit.

3. Enter the Apartment Number.

4. Enter the Description and Maximum Tenants.

5. Click Save Apartment to save the details

If the bed is not found an error is displayed. The screen is updated with Delete
Apartment button.

Index P a g e | 43
To discard the changes click Discard Changes.

Move In
This section displays the apartment details.

Figure 37: Apartment Details

Move Out
This section displays the apartment details.

Figure 38: Removing Tenant details

History

Admission History

Index P a g e | 44
Figure 39: Admission Details

Select a client to view the admission details.

If the client admission is cancelled, the details appear in non-editable mode and
an error message “Admission Status is cancelled” is displayed.

Figure 40: Client Identification

Index P a g e | 45
Re-Entry History
This section provides the Historical information regarding the Resident Re-Entry.

Select the Resident Re-Entry record to view/edit, the following screen is displayed
with the client details.

Figure 41: Re-Entry History

Select the resident to view the details. Note that the details appear in non editable
format.

Index P a g e | 46
Figure 42: Re-entry history details

It is mandatory to enter the Signature.

Click Edit and view the resident history. Click Update to save the changes to e-MAR.

Resident Discharge History


It provides the Historical information regarding resident discharges

• Select the resident to view

Index P a g e | 47
Figure 43: Discharge History

Figure 44: Discharge Details

Click Edit and view the resident historical Information. Click Update to save the
changes.

It is mandatory to enter the Signature.

Transfer History
This section allows you to View and edit the transfer history of the resident.

Index P a g e | 48
Figure 45: Transfer history

Select the resident from the resident list or else by using Search By or Selection
Filter.

The history details are displayed as shown below. Note that these details are in non
editable mode.

Index P a g e | 49
Figure 46: Transfer

Click Edit and view the transfer Information. Click Update to save the changes.

It is mandatory to enter the Signature.

Internal Transfer History


It allows you to View or edit resident internal transfer history.

Index P a g e | 50
Figure 47: Internal Transfer History

Select a resident from the resident list or else by using Search By or Selection
Filter
The client details appear in non editable mode as shown below.

Figure 48: View transfer details

Click Edit, the fields appear in editable format.

View or edit internal transfer information and click Update to save the information
else can discard the transfer.

Signature is mandatory to transfer the details.

Index P a g e | 51
Index P a g e | 52
Chapter 4

e-MAR
This chapter will introduce you to getting started
with eMAR module...............

Index P a g e | 53
e-MAR 4
MED e-care
Role-based security defines what applications and functions the user has to access.

Figure 49 : e-MAR

You can access e-MAR by clicking the e-MAR tab on the top of the screen. The Unit
details are displayed as shown below.

Figure 50: MAR/TAR

Index P a g e | 54
Check the appropriate options and click Go to view the unit details or click MED
Pass Status in MAR/TAR tab. Refer Figure 51 : Med Pass Schedule

MED / TAR Pass Status


Medication Administration Screen:

Select MED Pass Status to view the unit details as shown in Figure 50: MAR/TAR.
Click Go to view the MED Passes details.

Figure 51 : Med Pass Schedule

A warning message is popped up, with the number of pending follow-ups

Index P a g e | 55
Client Search Options
Scheduled
Once you are in the MAR administration screen, you can search residents by:

• Name
• Room
• Client Image
• F3 function opens up the ‘Find’ option
Scanning the barcode on the Resident Barcode List on the med-pouch

Click Scheduled for the MED Pass that you want to work with. Refer Figure 51 : Med
Pass Schedule

Figure 52: Med pass schedule

Click on image to view the client details.

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Figure 53: Client Search Options

Client Sort Options


Residents on the MAR administration screen can be sorted by:

• Room or Bed

• Last Name

• First Name

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The user can perform the sorting operation based on allotted bed and rooms.

Click Sorted By Room and Bed, to sort the client location.

Figure 54 : Client Sort Options

Administration & Information Update


Once a med-pouch has been scanned or the client card has been chosen, the
resident’s MAR will be displayed, including all the information you need to confirm:

5 Rights:

• Right Drug
• Right Client
• Right Dose
• Right Route
• Right Time

Figure 55 : Administration & Information Update

Index P a g e | 58
The scheduled client medication may be delivered on not delivered to the client.

• Medication Delivered

• Medication Not Delivered

Medication Delivered

When the medication is delivered the Delivered section is indicated in green color as
shown below.

Figure 56: Medication Delivered

To update the delivered medication section,

1. Click or touch the screen to update medication Delivered

The Time and Amount auto-populates


2. Enter the Waste Dosage(If necessary)
3. Click the Save button
Scan the next med-pouch or click on the next patient card to continue to the next
resident’s MAR

Medication Not Delivered

When the medication is not delivered the Not Delivered section is indicated in red
color as shown below.

Index P a g e | 59
Figure 57: Medication Not Delivered

To update the not delivered medication,

1. Click or touch the screen to update medication Not Delivered. The Not
Delivered section is updated with the failure notice.
2. Select a Reason Code or choose “Other” and enter the reason in the text-box
3. Enter the Waste Dosage (If necessary)
4. Click Save button
Scan the next med-pouch or click the next patient card to continue to the next
resident’s MAR.

PRN Administration
From the MAR administration screen, click the PRN button

Figure 58: PRN Administration

Index P a g e | 60
Figure 59: Alpha Menu

Select a resident by using the Alpha-menu or Search By Last Name or First Name.
The resident details are displayed as shown in the below screen.

Index P a g e | 61
Figure 60 : Client MAR record

To view the client MAR record,

1. Enter the Dosage (if required) and Reason for administrating the PRN in the
proceeding figure
2. Enter the Administration Time.
3. Enter the Reason.
4. Click Save MAR and Exit button.
If you require to administer another PRN for the same patient, just click the Save To
MAR button. e-MAR will record the PRN as delivered and will automatically generate
a one-hour follow-up reminder

Index P a g e | 62
To navigate to another client record, click Select Another Client

Administration Notes
Medication Notes can be viewed and created in e-MAR.

• White Note:
Indicates No note attached

• Blue Note:
Indicates a non-follow-up note attached

• Red Note:
Indicates a follow-up is required

Figure 61: Client Details

To view a note

Click on the note icon to document information for a medication or treatment.


The Administration Notes window is displayed.

Index P a g e | 63
Figure 62: Client Demographics

When you check the Require Follow-Up checkbox, a follow-up alert is generated for
the specified Follow-Up Date and Time and turns red.

Click Add Note to update the system.

BIO Tests
Click on the thermometer provided in the Special Instructions sections to view
the details.

Index P a g e | 64
Figure 63: Bio Tests

The thermometer icon indicates BIO Tests, which can be associated with a
medication or treatment

A red thermometer indicates that BIO Test results need to be viewed or


recorded before the medication is administered

Enter BIO Test Results, click the thermometer icon to view the BIO Measurement
Management screen. Click Client BIO Test/ Management for MAR tab

Complete Test:
It helps in entering a new BIO Test.

Index P a g e | 65
Figure 645 : Entering BIO Test/Measurement for MAR

To complete a test,

1. Select the Bio test

Highlight the BIO test you would like to enter a measurement for
2. Click New, the following screen is displayed.

Index P a g e | 66
Figure 65Bio Test details

3. Enter the new BIO Test results


4. Click Save button to update e-MAR

Creating a BIO Test:

Index P a g e | 67
Figure 66: Creating a Bio Tests

To Create/Associate Test,

1. Click on the middle tab to Create/Associate Test


2. Click on New, enter the test order details.
3. Select the Test Type, Time of Day, Frequency details and enter the
Instruction details to determine which BIO test is required
4. Click Save

Index P a g e | 68
Associating a BIO Test:

Figure 67: Associating a Bio Tests

To associate a bio test,

1. Click on the middle tab to Create/Associate Test


2. Select the test type and click Associate.

Ensure the BIO test to be associated is highlighted.


When a ‘+’, is displayed beside the test type, it indicates the BIO test is now
associated.

History of Test:

It helps in viewing the BIO Test Results

Index P a g e | 69
Figure 68: Client BIO Test/Measurement Results

To view the History of Bio test details,

1. Click the thermometer icon to view the BIO Measurement Management screen
2. Click on History of Test tab
3. Double-click the BIO Test you want to view. The Vital Signs Form will be
displayed as shown below.

Index P a g e | 70
Figure 69 : Vital Signs

4. Review the BIO Test results by clicking on the test


5. Click the Close button to exit the window

Manage Orders
To access the Manage Orders feature, click on Physician Order in the sidebar.

The Manage Orders feature includes:

• Hold
• Discontinue
• Reorder

Index P a g e | 71
Figure 70: Hotlist details

Select a resident in order to access his/her medication orders

Index P a g e | 72
Figure 71 : Active Orders

Figure 72 : Client Orders

To manage the click orders,

1. Check the order you want to manage


2. Click the Hold, Discontinue or Reorder button

Manage Orders – Put Orders ON HOLD

Select the resident and the medication to put on HOLD. Click the button to
display the Enter Medication screen

Index P a g e | 73
Figure 73 : Manage Orders - Put Orders on Hold

• Medications flagged ON HOLD will appear on the Order List

Figure 74 : Order List

• Modify the Effective Date, Time, Release Date and Time (if required). Click
the Hold All button to confirm whether all orders on the list are placed on
Hold or not
• To remove medications from the list, highlight the orders & click the Remove
from List button
Manage Orders – DISCONTINUE Orders

Select the resident and the medication to DISCONTINUE

Click the button to display the Enter Medication screen

Index P a g e | 74
Figure 75 : Manage Orders - Discontinue orders

Medications flagged DISCONTINUED will appear on the Order List

• Modify the Effective Date and Time (if required). Click the Discontinue All
button to confirm whether all orders on the list must be discontinued or not
• To remove medications from the list, highlight the orders & click the Remove
from List button
Manage Orders – REORDER Medications

Select the resident and the medication to REORDER

Index P a g e | 75
Click the Button to display the Enter Medication screen

Figure 76 : Manage Orders - Reorder Medications

Orders flagged for REORDER will appear on the Order List

Figure 77: Reorder List

• Modify the Effective Date and Time, if required. Click the Send Order
button to confirm that all orders on the list should be reordered
• To remove medications from the list, highlight the orders & click the Remove
from List button

Index P a g e | 76
Manage Orders from the MED Pass Screen
Click Manage Order button on the MAR administration screen

Figure 78 : MED Pass Screen

From the administration screen, the user has the ability to:

• Hold
• Discontinue Order
• Reorder

Index P a g e | 77
Figure 79: Medication Order information

Hold:

Index P a g e | 78
Figure 80: Hold Order

To place an order on Hold,

1. Click the Hold Order button


2. Enter the Effective Date and Time
3. Enter the Release Date and Time
4. Click the Place a Hold button, a confirmation message is displayed.

Click Ok.

The Hold Order button is replaced by Release from Hold button.

Index P a g e | 79
Figure 81: Release from Hold

To Release from Hold, click on the Release from Hold button to confirm release

Discontinue:

Index P a g e | 80
Figure 82: Discontinue Order

To Discontinue an Order:

• Click on the Discontinue Order button


• Enter the Effective Date and Time
• Click on the second Discontinue Order button to confirm

The Discontinue Order button is replaced by Release from Discontinue


button.

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Figure 83: Release from Discontinue

To Release from Discontinue, click on the second Release from Discontinue button
to confirm

• Reorder:

Index P a g e | 82
Figure 84: Reorder

To reorder a medication:

• Click on the Reorder button


• Enter the Effective Date and Time
• Click on the Send order button

MAR Screen for Medications ON HOLD or DISCONTINUED


When medications are placed ON HOLD, administration screen will instantly alert
the user indicating that the medication should be pulled from the med-pouch.

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Figure 85: Medications on Hold

The administration screen updates medications that are DISCONTINUED indicating


that the medication should be pulled from the med-pouch

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Figure 86: Medications Discontinued

Manage Follow Ups/Overdue/Test -- Hotlist


The Hotlist displays overdue tasks:

• Follow-up Overdue
• Follow-up due Today
• Medication
• Treatment
• Associated BIO-Test
• All

Click List, to view the MED/Follow up/Bio test details. These Hotlist details can be
accessed through e-ADT, click Information Post and then click Bulletin.

Figure 87: Hotlist

Or

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To access Hotlist from the MED Pass Status screen, click Hotlist button.

Figure 88: MED Pass details

The Selection Filter allows items to be sorted by:

• Follow-up Overdue
• Follow-up due Today
• Medication Overdue
• Treatment Overdue
• Associated BIO-Test Overdue
• All

Figure 89: Bio test hotlist details

Index P a g e | 86
The Search By function allows data to be sorted by:

• Name
• Chart Number
• Room
• Bed

Quick Reports
Current Pass Time Reports contains information about the current MED Pass which
includes MAR List, TAR, Associated Medication BIO Test and Follow-up List.

Figure 90: Current Pass Time Report

Index P a g e | 87
Today Reports will show information for the full day which includes MAR List, TAR,
Associated Medication BIO Test, Follow-up List, PRN List, and Drug Control.

Figure 91: Today Report

Overdue Reports will show information about the overdue items which includes MAR
List, TAR, and Follow-ups.

Figure 92: Overdue Reports

Tracking of New Orders and Reorders


MED e-care’s e-MAR software allows users to track medication that has been ordered
using Manage Orders. All Medication Orders sent (New or Reorders) will appear on
the MAR administration screen. This reminds the nursing staff that an order for a
particular medication has been sent to the pharmacy and is awaiting delivery.
Information remains on the administration screen by default for 5 days (days can be
changed). Once the order is received, the medication will longer be displayed as a
NEW ORDER on the administration screen. The staff also has the ability to manually
delete the ORDER by clicking on the ‘X’.

Index P a g e | 88
Figure 93: Tracking New Order

Order – Add to MAR Now


• Add to MAR Now option is used to add and document emergency-stock
medication to a resident’s MAR
• To access Add to MAR, click Physician Order and then click Add to MAR
Now

• Choose the Resident

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Figure 94: Add Medication Order to MAR Now

To Add MAR/TAR,

Order Number is auto generated.

Index P a g e | 90
1. Select the Physician type and Order Date.
2. Select the appropriate Order Type and the Pharmacy Source
3. Enter the mandatory fields in Order Details

Start Date and Time can be modified (if required). The Special
Instructions can be entered in the text box provided.
4. Click the Add to MAR Now button

If the pharmacy is sending the remaining balance for the medication order, check the
‘Pharmacy will supply balance’ check-box

Figure 95: Order details

A reminder is created on the MAR Administration screen which informs the users that
the original order should be discontinued once the new order has been received. To
discontinue the order, click the Manage Order button.

Figure 96: client information

Index P a g e | 91
Click Manage Order to view the client details.

Figure 97: client medication details

To discontinue the order,

1. Click the Discontinue Order button


2. Enter the Effective Date and Time
3. Click the Discontinue Order button
4. Click the Close button

If required, the new order may be discontinued at a future date (e.g. antibiotics). To
determine the discontinue date; click the Manage Order button for the new
medication order.

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Click the Print Order Scheduled button

Figure 98: client order details

A Medication Administration Record Sheet Report will be generated which displays


the history of administration for that specific medication.

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Figure 99: medication record sheet

Order – MAR/TAR Notes


To access Add Standing Order, click Physician Order and then click Add
Standing Order
Select Physician, Client and Order Type as MAR Note

MAR and TAR Note  notes such as ‘Crush Meds’ that do not need to be
signed off

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Non Medication MAR or TAR Order  notes such as ‘Boost’ that need to be
signed off

Figure 100: Add MAR/TAR Notes

1. Check the Pharmacy Source


2. Enter the mandatory fields in Order Details
Fill the order details,
3. Select the Frequency and enter the Duration.
4. Select the Start Date & Time(if necessary)
5. Enter the Special Instructions.
6. Click Add to MAR Now button

Physician Order – Enter New Order


• To access Enter New Order, click Physician Order and then click Enter New
Orders

Index P a g e | 95
Index P a g e | 96
Figure 101: Enter new Medication Order

1. Select Resident, Order Type and Drug


2. Enter Strength Amount and Unit (e.g. 500 mg)
3. Enter Drug, Strength Amount and Unit Information in the Order
Instructions box provided

4. Click the Add Order button. e-MAR will update the Order List

Index P a g e | 97
Continue adding orders for all the residents until all the orders are completed

Figure 102: Error Message

When all orders have been entered, click to submit the orders to the
pharmacy. Click OK on the order confirmation window

Order-Receive Orders

Figure 103: Order- receive orders

Order – Sign, Print, or Fax Physician Orders to the


Pharmacy
When submitting a new order to the pharmacy, e-MAR will generate a

Physician Medication Order Form

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Figure 104: Physician Medication Order Form

The Physician Medication Order Form displays:

• Facility Information
• Pharmacy Information (Phase II)
• Client Information
• Physician Information
• Order Number
• Medication
• Dosage if entered
• Physician Instructions
• Administration Date
The physician can sign and date the order with a stylus, electronically transmit or
print and fax the order to the pharmacy

Order – Waste Dosage Management


Waste Dosage entered during administration is managed through Waste Dosage
Orders option. Users are able to select orders which are submitted to the pharmacy
or they are deleted from the waste dosage orders list.

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Figure 105: Waste Dosage Order

1. Select the order


2. Click Send Order

Order-Unsigned Orders
Click Unsigned Orders to view the physician orders.

Index P a g e | 100
Select the Physician, the list of unsigned orders by the physician are displayed as
shown in the following figure.

Figure 106: unsigned orders

Generate Previous Order Report


Click Generate Previous Order Report

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The following screen is displayed. Select the type and enter the number to search
the details.

Figure 107: order Reports

Leave of Absence - LOA


When a patient is leaving the facility for a long period of time (i.e. Vacation, Home
care) for 1 day or more, the LOA option can be used for the duration of the leave.
This will allow the user to input a start date and return date of the leave and all
medication will be moved to the ‘Not Delivered’ for the duration.

OR

Index P a g e | 102
Figure 108: MED pass details

• Click on one of the LOA options


• Choose All from the drop down and then the patient to put on LOA

Index P a g e | 103
Figure 109: LOA details

• Enter in the Effective Date and Time, and the End Date and Time with a reason
from the drop down menu and then click OK

Figure 110: client demographics details

Index P a g e | 104
• The following will be shown in the ‘Not Delivered’ section for the duration of
the LOA
• While on LOA, the ‘Delivered’ and ‘Not Delivered’ will be locked out and
medication cannot be administered during this time

Index P a g e | 105
Index P a g e | 106
Chapter 4

e-MAR Reports
This chapter will introduce you to generating
and viewing reports in e-MAR

Index P a g e | 107
E-MAR REPORTS 1
Individual-Group Reports
Click the e-Reports tab at the top of the screen

Figure 111: e-reports

• Select one of the Individual or Group Reports from the following screen:
• In this example, the Medication Administration Record Sheet Report is
selected

Index P a g e | 108
Figure 112: e-reports list

Index P a g e | 109
Fill in the necessary fields to customize the report

Figure 113Medication history reports

• Click the Run Report button


• e-MAR will generate a report, which can be viewed online or in printed format

Index P a g e | 110
Figure 114: Medication Administration record sheet

Index P a g e | 111
Index P a g e | 112
Chapter 5

Recommended e-MAR
Procedures

Index P a g e | 113
R
E 5
C
O
M
1. Login to e-MAR
M 2. If you haven’t done so, click My Account tab and change your password from
the default
E
N Figure 115: My account

D 3. Click the e-MAR tab to access the MED Pass Status Screen

E
Figure 116: e-MAR
D 4. Select the relevant Nursing Unit(s)
5. To access the MED Pass administration screen, enter the ‘Scheduled’ pass,
E then scan the resident’s barcode or click on the client image
- 6. To record administration of medications, click either Delivered or Not
Delivered (with accompanying reason code)
M7. To place an order on Hold, Discontinue or Reorder, use the Manage Order
button on the administration screen :
A
R
P 8.9. Scan the next barcode to access the next patient’s MAR
When the administration of meds has been completed for the med-pass, click
R the Done button to return to the MED Pass Status screen

O
10.Review the status of the Scheduled, Delivered, Overdue, Not Due Yet, and Not
C Delivered medications listed for the completed MED Pass

E
D
U
R
Index P a g e | 114
E
S
Figure 117: MED Pass Status details

11.If necessary, click Scheduled, Delivered, Overdue, Not Due Yet and Not
Delivered to access these medications
12.Click the Hotlist button on the top of the screen to review Post Medication
Follow-ups that may be overdue:

13.Click on the patient name to access the Follow-up


14.Once the follow-up has been completed, click the Follow-up Completed
checkbox and click the Done button
15.When all the Post-Medication Follow-ups have been completed, click Logoff on
the top right-hand corner of the screen

Index P a g e | 115
G
L
O
URL : Uniform Resource Locater

ADT : Admission Discharge and Transfer


S
MAR : Medication Administration Sheet
S
TAR : Treatment Administration
A
BIO : BIO Test
R
Y

Index P a g e | 116
I
N
D
E A

X
Accessibility, 11
Administration, 34
Admission History, 45
advance directives, 14
Allergies, 24
antibiotics, 98
Apartment Management, 43
appropriate, 37
Associate Test, 71
Associated BIO-Test Overdue, 90
automatically, 66

B
Barcode, 8
Bed Swap, 41
BIO Test, 68
Blue Note, 66
Bulletin, 15

C
Client Admission, 14
Client Health, 24
Client Health Status, 24
Client Identification, 21
Client Management, 15
Client Sort, 59
Current Admission, 27

D
demographic, 14
diagnoses, 14
Discharge, 14
DISCONTINUE Orders, 77
Dosage, 65
Dose, 60

E
e-MAR, 56

Index P a g e | 117
e-MAR Reports, 116
e-MAR schedules, 33
emergency, 94

F
Follow-Up, 67

H
Historical, 46
History, 45
Hotlist, 88

I
Individual-Group, 116
Information Post, 89
Internal Transfer History, 51
Internal Transfer of Client, 39

L
Leave of Absence, 111

M
Mandatory, 32
MAR/TAR Notes, 100
MED / TAR Pass Status, 57
MED e-cares, 8
MED Pass, 80
Medication Administration, 57
Medication Delivered, 61
Medication Overdue, 90
Medications, 24
med-pouch, 60
Move Out, 44

O
ON HOLD, 77
Orders, 74

P
Paperwork, 34
pharmacy, 96
Physician Order, 94
POA-Personal Care, 18
Pre-Admit, 26
PRN Administration, 63

Index P a g e | 118
R
Red Note, 66
Re-Entry, 30
Re-Entry History, 46
REORDER Medications, 78
Resident Contacts, 22
Resident Discharge History, 48
Retirement, 43
Right Drug, 60

S
Scheduled, 58

T
thermometer, 68
Transfer, 14
Transfer History, 49
Transfer information, 14
Transfer Information, 36
Treatment Overdue, 90
Treatments, 24

U
Unsigned Orders, 109

V
Vital Signs, 74

W
Waste Dosage, 62
Waste Dosage Management, 108
White Note, 66

Index P a g e | 119
Index P a g e | 120
MED e-Care Healthcare Solutions
Inc
Corporate Headquarters
710 Kingston Road
Toronto, Ontario M4E 1R7
CANADA
Telephone: (416) 686-8592 (Toronto)
0808-101-2783 (United Kingdom)
Toll Free: 1-800-387-8903
Fax: (416) 686-3861

Web: www.mede-care.com | E-mail: info@mede-care.com|Telephone: (416) 686-


8592

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