Table 3

Transcription considerations

Should the team print Medchart EPMA to paper and then use that paper chart to transcribe to Nervecentre EPMA?
  • Paper drug charts must remain on the ward for drug administration and emergency prescribing. Thus, transcribing would have to be done on or near the ward.

  • Once drug charts are printed the old application can be made view only for the whole ward that is transitioning. This avoids two live electronic drug records for a patient and risk of dual records causing confusion especially with remote prescribing ability.

Should the transcribing take place on the ward or in a remote location?
  • During the pandemic it was necessary to minimise staff working on the ward.

  • Wards are busy places and often do not have many free computers or desk space that would be needed by a transition team.

  • If transitioning without paper it is probably easier to use a remote location set up specifically for the task in hand.

  • The team therefore decided to conduct the transition process away from the ward.

How long should two live EPMA applications overlap for a patient?
  • The Team aimed to keep this to a very short period (2–3 hours). During this window, there is a risk of drugs being prescribed or administered on the wrong application.

  • The time taken to transition a whole ward will depend on the number of patients and size of the transition team.

How do the team prevent the wrong EPMA application being used for a patient?
  • Keep the overlap window to a minimum.

  • Turn off the prescribing function (but not administration) when the transition process started for a particular ward.

  • All new patients on the day of transition have medications prescribed on the new application.

  • Clear staff communication about the process and risks.

  • Use identifiers on the ward whiteboard of patient names or patient bed to indicate which application the staff needed to use. For example, a new admission is on the new application but they are moved to a ward that is not transitioning until later in the day.

  • EPMA, Electronic Prescribing and Medicines Administration.