title: Efficiency and usability of a near field communication-enabled tablet for medication administration.
abstract: BACKGROUND
  Barcode-based technology coupled with the electronic medication administration record (e-MAR) reduces medication errors and potential adverse drug events (ADEs). However, many current barcode-enabled medication administration (BCMA) systems are difficult to maneuver and often require multiple barcode scans. We developed a prototype, next generation near field communication-enabled medication administration (NFCMA) system using a tablet.
  
  
  OBJECTIVE
  We compared the efficiency and usability of the prototype NFCMA system with the traditional BCMA system.
  
  
  METHODS
  We used a mixed-methods design using a randomized observational cross-over study, a survey, and one-on-one interviews to compare the prototype NFCMA system with a traditional BCMA system. The study took place at an academic medical simulation center. Twenty nurses with BCMA experience participated in two simulated patient medication administration scenarios: one using the BCMA system, and the other using the prototype NFCMA system. We collected overall scenario completion time and number of medication scanning attempts per scenario, and compared those using paired t tests. We also collected participant feedback on the prototype NFCMA system using the modified International Business Machines (IBM) Post-Study System Usability Questionnaire (PSSUQ) and a semistructured interview. We performed descriptive statistics on participant characteristics and responses to the IBM PSSUQ. Interview data was analyzed using content analysis with a qualitative description approach to review and categorize feedback from participants.
  
  
  RESULTS
  Mean total time to complete the scenarios using the NFCMA and the BCMA systems was 202 seconds and 182 seconds, respectively (P=.09). Mean scan attempts with the NFCMA was 7.6 attempts compared with 6.5 attempts with the BCMA system (P=.12). In the usability survey, 95% (19/20) of participants agreed that the prototype NFCMA system was easy to use and easy to learn, with a pleasant interface. Participants expressed interest in using the NFCMA tablet in the hospital; suggestions focused on implementation issues, such as storage of the mobile devices and infection control methods.
  
  
  CONCLUSIONS
  The NFCMA system had similar efficiency to the BCMA system in a simulated scenario. The prototype NFCMA system was well received by nurses and offers promise to improve nurse medication administration efficiency.
authors.affiliation: Brigham and Women's Hospital, Department of Emergency Medicine, Boston, MA, United States. alandman@partners.org.
authors.forename: Adam
authors.initials: A
authors.lastname: Landman
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Neri
authors.forename: Alexandra
authors.initials: A
authors.lastname: Robertson
authors.forename: Dustin
authors.initials: D
authors.lastname: McEvoy
authors.forename: Michael
authors.initials: M
authors.lastname: Dinsmore
authors.forename: Micheal
authors.initials: M
authors.lastname: Sweet
authors.forename: Anne
authors.initials: A
authors.lastname: Bane
authors.forename: Sukhjit S
authors.initials: SS
authors.lastname: Takhar
authors.forename: Stephen
authors.initials: S
authors.lastname: Miles
keywords: automatic data processing; medication errors; medication systems; mobile applications; nursing
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