Summary
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.
Keywords
Interfaces and usability - Human-computer interaction - Medication administration
records - Electronic health record - Testing and evaluation