Evaluation of a BCMA's Electronic Medication Administration Record.

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Nursing Informatics

Background:

• Barcode medication administration (BCMA) systems are critical for reducing medication errors.
• Sociotechnical issues frequently arise with BCMA implementation.
• Usability evaluations of electronic medication administration record (eMAR) screens are notably scarce, despite their importance for nursing workflows.

Purpose of the Study:

• To identify current usability problems within the Veterans Affairs (VA) eMAR/BCMA system.
• To explore the potential impact of these usability issues on nurses' situation awareness (SA).

Main Methods:

• Utilized heuristic evaluation techniques with three expert evaluators.
• Evaluated 99 usability problems across 10 specific tasks and elements.
• Assessed potential impacts through a situation awareness (SA) lens.

Main Results:

• Identified 440 heuristic violations, with the most frequent in the 'Match With the Real World' category.
• Rated 15 usability issues as catastrophic, particularly within the 'Administer/Chart medications' task.
• Found that usability problems affected all levels of nurses' SA, most significantly at Level 2 (Comprehension).

Conclusions:

• Identified significant usability problems in the VA's eMAR/BCMA system.
• These issues can negatively impact nurses' situation awareness, immediate information access, productivity, and ultimately, patient safety.
• Recommendations for system improvement are indicated to enhance usability and mitigate risks.