Bar Code Medication Administration and MAR Resource Manual
Alerts and Common Errors
CareMobile Alerts .......................................................................................................................2
Common Errors ..........................................................................................................................7
1
CareMobile Alerts
Do Not Ignore Alerts!
1. Product not found
Wrong bar code was scanned or the bar code is defective.
The organization may not have been selected when prompted.
Patient ID Band:
 The linear bar code was scanned rather than the 2-D bar code
 The name band is for the wrong account (visit)
 The ID band may need to be replaced
 Wrong organization or organization has not been selected (see #2)
Medication:
 The manufacturer’s bar code was scanned on the IV product instead of the
MMC pharmacy label
 The bar code is defective. Place the label in the “Broken Bar Codes”
envelope for pharmacy. Tap the med task to continue
 Non-formulary meds may not scan. Tap the med task to continue
2. Select Organization
Select Organization window displays when the PDA cold boots (low battery). The ID
band will not scan if the window is canceled or the wrong organization is selected.
 To check organization. Tap Tasks at the bottom of the screen.
Tap Pick Organization
3. Scanned dose is more than ordered dose
Displays when med product is in a larger dose than ordered
 The wrong product may have been scanned. Pharmacy may have sent
the wrong product.
 Tap Yes, if the medication is going to divided into the correct dose
 Check the order detail on the Charting window to make sure you
administer the correct dose
 Enter the correct dose in the dose field, which will less than the product
amount
2
4. There are pending tasks that need to be signed
Displays when exiting CareMobile or opening another patient’s chart
 Tap No to sign all meds that have been scanned
 If Tap yes, all scanned meds will be lost
5. Scheduled meds have not been administered
Displays when changing patients and tasks are in the Due Tasks folder or RT folder
 These tasks have not been scanned so you will not lose any data when
switching patients.
 A similar alert displays for RT tasks. Do not complete RT tasks.
6. Scanned patient does not match the patient profile
Displays when the patient’s ID band does not match the patient in CareMobile
 The wrong patient has been scanned
 Investigate. The patient may have an incorrect ID band or you may have
gone to the wrong room or bed.
 When scanning the ID band to open the patient’s chart, the alert notifies you
that you are opening another patient’s chart. Tap Yes
3
7. Tasks not found
This alert needs investigation in CareMobile and the MAR Summary
1st Go to the MAR Summary
 Check if the meds are due for the current 1 hour time frame
 If the patient was just admitted, pharmacy may not have entered the orders.
nd
2 Check CareMobile
 Check “As Of” time. If the As Of time does not match the time at the top of
the window, tap As Of to refresh the view.
 Verify the correct patient’s chart is open
 The PDA may be jammed. Reset the PDA
8. Medication not found in Task list
This alert needs investigation
 The alert may indicate that you are giving the wrong med or at an incorrect
time
 Tap Yes if you are creating a new order to give a Stat or Now med.
9. Medication has not been verified by a pharmacist
Displays when the pharmacist has not reviewed the medication order.
 If tap Yes, the pharmacy alerts for allergies, interactions and duplicate
therapy open
 The nurse takes responsibility that the order is correct for the patient.
 Do not administer a med that has not been verified by the pharmacist unless
it is critical to the care of the patient.
4
10. Medication Order has changed since the last PDA refresh.
A change was made
between the ‘As Of’ time
and the actual time.









Tap OK
Meds that have not been
changed will chart and no
longer display
Meds that changed will
remain on To be Signed.
Right-click and select
Remove
Tap ‘As Of’ to refresh
If you refresh without
removing the meds, this
alert displays
Tap Yes
Meds will be removed
from To be Signed
Go to the MAR Summary
to view the medication
changes
5
11. The application has timed out
Displays when the PDA has not been used for 1 hour
 If same user, enter password
 If different user, enter user name and password. Rest PDA is spinning
occurs longer than 1 minute.
 To avoid, always tap Workflow and Exit when charting is completed.
6
Common Errors
Reading the pop-up Alerts and reviewing med charting on the PDA prior to signing will
prevent errors. After signing, always review charting on the MAR Summary.
Topic: Creating New Orders in CareMobile
Error: Patient receives 2 doses of a medication. Here’s how it happens.
Nurse creates an order for the med. Pharmacy enters order after the nurse creates an order in
CareMobile.
Order the nurse
created
Order entered
by Pharmacy
The order that the nurse created automatically
discontinues (gray) when charted.
Prevention: Always check Last Given dose in CareMobile or on the MAR Summary.
Write “Med Given” on the order sheet that goes to pharmacy. Initial, time and date the
notation. This notifies pharmacy the order has already been entered.
Do not give a medication that has not been Nurse Reviewed
Tap and hold on the med task.
Tap Last Given.
The nurse should review the MAR Summary prior to giving meds for an overview of med
orders (see above).
On the MAR, the order created by the nurse displays in the discontinued order section. The
section displays after the active orders sections and is not as easy to view as the MAR
Summary.
7
Topic: Documented Dose does not match Ordered Dose
Error: Nurse records the wrong dose. The medication requires 2 or more packages to be
scanned but the nurse only scans one med.
Select a Task opens
to alert the nurse the
dose is incorrect
Order Detail
The nurse does not
scan the next
package. Instead the
nurse taps the task
200 mg was
ordered
Only 100 mg
was scanned
Nurse signed incorrect
dose as shown on the
patient’s chart
Prevention: Scan all packages to meet the dose. If you tap the task, compare the scanned
dose to the ordered dose to make sure it is accurate.
Topic: Charting free text doses
Error: Wrong doses and units of measure are recorded.
Prevention: Review your documentation on the charting window before signing.
8
Topic: Pain Response tasks are not addressed
Problem: Many Pain Responses are accumulating in the Overdue folder in CareMobile
Solution: Chart Not Done in PAL if the Pain Reassessment has been completed through AD
Hoc Charting. Remember Ad Hoc Charting does not remove the tasks from CareMobile.
Click Chart Not Done if
pain reassessment has
already been documented
or it’s not appropriate.
Click Chart Details if the
pain reassessment needs
to be documented.
Topic: Order is not Nurse Reviewed nor verified by a Pharmacist
Error: Patient received wrong medication. The order sheet had the wrong patient label.
The med orders were entered on the wrong patient by a pharmacy tech. The orders had not
been nurse reviewed.
Another example of an error: Patient received 2 doses. Orders were faxed to pharmacy and
later the pharmacy copy was delivered to pharmacy. The pharmacy tech entered the orders
twice. The orders had not been nurse reviewed nor verified by a pharmacist.
Prevention: Do not administer medications if the order has not been
Nurse Reviewed,
, nor verified by a pharmacist
.
Do not administer
meds if either of
these indicators is
present.
If administering the medication is critical to the care of the patient, compare the order on the
PDA with the written physician’s order before administration
9
Topic: Uncharting an IVPB on the I&O
Error: Nurse uncharted the IVPB volume when trying to correct the volume recorded.
The IVPB task reappeared in CareMobile making it possible to administer another dose. The
nurse had to re-chart the IVPB in CareMobile by re-scanning the med, changing the time and
scanning the patient again to correct the error.
Solution: Do not unchart an IVPB volume on the I&O tab. Use Modify to change volume
Prevention: Change the infuse over time in CareMobile at the time of medication
administration
Tap the Infuse
volume Icon
Change the Infuse
Over fields
10
Topic: Not able to chart IV volumes on I&O
Problem: IV was not scanned or the Begin Bag time is after the time you are charting
I&O.
Solution: The IV charting window opens with required fields. Exit the window. Scan the IV. To
change the time on an IV that has been charted, go to the MAR and right-click on Begin Bag.
Select Modify.
The result window indicates the Begin
Bag has not been done (no data).
The yellow fields are required fields,
indicating the IV was not scanned.
Click the X to close the window
Change the performed time when back charting so that the volume will auto-populate I&O in
the correct time cell.
Click the Calendar to change the performed time
To correct the time after signing. Go to the MAR.
Right-click on
Begin Bag
Click Modify
11
Topic: Order Comments
Error: Meds are given incorrectly because the order comments have not been read.
Prevention: Read the order comments on the MAR, MAR Summary or CareMobile (PDA).
Order Comments are indicated by
on the MAR and CareMobile.
CareMobile
Tap and hold on med task
Tap Order Details
Tap Comments
Tap Drop down arrow
to view all comments
MAR
Click on the
MAR Summary
Hover on the Order
Click on Order Info
Click Comments tab
12
Topic: Medication is missed
Error: The Unscheduled Meds folder was not checked
Prevention: Look for a number listed next to the Unscheduled Meds folder. The number
indicates tasks are in the folder.
Topic: Medication is missed
Error: The PDA was not refreshed on a regular basis
Prevention: As Of function is critical to ensure medications are not missed. To avoid issues
validate that current time is the same as the AS Of time. Click As Of to rectify
Current time
Time of last refresh
Topic: Scanning by-passed due to a scanning error.
Error: Wrong med given to the patient. There have been several errors where the nurse
scanned the med, received an alert stating “Product Not found” or “would you like to create an
order” and decided to give the medication without scanning. The bar code was not faulty but
rather, the nurse was trying to scan the wrong med. Nursing bypassed scanning and did not
follow the 7 Rights of Medication Administration.
Prevention: Do not assume the bar code or PDA is not working because a bar code does not
scan. Follow the 7 Rights of Medication Administration. Make sure you have the right patient,
right drug/dose/time/route, right reason and right documentation.
13
14