BACKGROUND: Electronic medication administration records (eMARs) have been widely used in recent years. However, formal usability evaluations are not yet available for these vendor applications, especially from the perspective of nurses, the largest group of eMAR users. OBJECTIVE: To conduct a formal usability evaluation of an implemented eMAR. METHODS: Four evaluators examined a commercial vendor eMAR using heuristic evaluation techniques. The evaluators defined seven tasks typical of eMAR use and independently evaluated the application. Consensus techniques were used to obtain 100% agreement of identified usability problems and severity ratings. Findings were reviewed with 5 clinical staff nurses and the Director of Clinical Informatics who verified findings with a small group of clinical nurses. RESULTS: Evaluators found 60 usability problems categorized into 233 heuristic violations. Match, Error, and Visibility heuristics were the most frequently violated. Administer Medication and Order and Modify Medications tasks had the highest number of heuristic violations and usability problems rated as major or catastrophic. CONCLUSION: The high number of usability problems could impact the effectiveness, efficiency and satisfaction of nurses' medication administration activities and may include concerns about patient safety. Usability is a joint responsibility between sites and vendors. We offer a call to action for usability evaluations at all sites and eMAR application redesign as necessary to improve the user experience and promote patient safety.
BACKGROUND: Electronic medication administration records (eMARs) have been widely used in recent years. However, formal usability evaluations are not yet available for these vendor applications, especially from the perspective of nurses, the largest group of eMAR users. OBJECTIVE: To conduct a formal usability evaluation of an implemented eMAR. METHODS: Four evaluators examined a commercial vendor eMAR using heuristic evaluation techniques. The evaluators defined seven tasks typical of eMAR use and independently evaluated the application. Consensus techniques were used to obtain 100% agreement of identified usability problems and severity ratings. Findings were reviewed with 5 clinical staff nurses and the Director of Clinical Informatics who verified findings with a small group of clinical nurses. RESULTS: Evaluators found 60 usability problems categorized into 233 heuristic violations. Match, Error, and Visibility heuristics were the most frequently violated. Administer Medication and Order and Modify Medications tasks had the highest number of heuristic violations and usability problems rated as major or catastrophic. CONCLUSION: The high number of usability problems could impact the effectiveness, efficiency and satisfaction of nurses' medication administration activities and may include concerns about patient safety. Usability is a joint responsibility between sites and vendors. We offer a call to action for usability evaluations at all sites and eMAR application redesign as necessary to improve the user experience and promote patient safety.
Entities:
Keywords:
Electronic health record; Human-computer interaction; Interfaces and usability; Medication administration records; Testing and evaluation
Authors: D W Bates; G J Kuperman; E Rittenberg; J M Teich; J Fiskio; N Ma'luf; A Onderdonk; D Wybenga; J Winkelman; T A Brennan; A L Komaroff; M Tanasijevic Journal: Am J Med Date: 1999-02 Impact factor: 4.965
Authors: Hagop S Mekhjian; Rajee R Kumar; Lynn Kuehn; Thomas D Bentley; Phyllis Teater; Andrew Thomas; Beth Payne; Asif Ahmad Journal: J Am Med Inform Assoc Date: 2002 Sep-Oct Impact factor: 4.497
Authors: Carol A Keohane; Anne D Bane; Erica Featherstone; Judy Hayes; Seth Woolf; Ann Hurley; David W Bates; Tejal K Gandhi; Eric G Poon Journal: J Nurs Adm Date: 2008-01 Impact factor: 1.737
Authors: Ross Koppel; Joshua P Metlay; Abigail Cohen; Brian Abaluck; A Russell Localio; Stephen E Kimmel; Brian L Strom Journal: JAMA Date: 2005-03-09 Impact factor: 56.272
Authors: Barbara Sinclair; Richard Booth; Josephine McMurray; Gillian Strudwick; Gavan Watson; Hanif Ladak; Merrick Zwarenstein; Susan McBride; Ryan Chan; Laura Brennan Journal: JMIR Res Protoc Date: 2018-05-28
Authors: Margie E Snyder; Heather Jaynes; Stephanie A Gernant; Julie DiIulio; Laura G Militello; William R Doucette; Omolola A Adeoye; Alissa L Russ Journal: BMC Med Inform Decis Mak Date: 2019-07-16 Impact factor: 2.796