Introduction: To improve safety practices for vulnerable residents in long-term care facilities (LTCFs), electronic medication administration records (eMARs) are widely adopted. This study aimed to (1) explore the current implementation situation of eMARs in LTCFs (2) develop a logic model for adopting eMAR in LTCFs and (3) explore the contextual factors relevant to the implementation process. Methods: First, a literature review was conducted to explore the current situation of eMARs implementation in LTCFs, including impact, barriers and challenges and uptake of eMARs in LTCFs. Second, 57 in-depth, semi-structured key stakeholder interviews were conducted between February and March 2021 to explore the experiences with eMAR in LTCFs in Macao. Purposive sampling was used for recruitment and thematic analysis following the theoretical framework of the logic model was employed. Results: Most research focused on the eMARs impact on quality of care through reduction of medication errors during administration process, improving efficiency and reducing work redundancy. The barriers and challenges of adopting eMARs mainly included financial barriers and non-financial barriers. In the key stakeholder interviews, all 57 participants were generally positive about adopting eMARs in LTCFs. While financial resources such as sufficient funding to acquire internet access and to procure hardware and software were deemed important, nonfinancial resources such as high-level commitment, the process of transforming from paper-base to eMARs, and training and communication were also perceived critical to incorporating eMARs into daily practice. The mostly adopted eMARs functions included documentation, e-prescribing, reminders and real-time monitoring of administration. The most important output observed included simplified drug administration process, reduced manual errors, and timely communication among staff. The outcome of adopting eMARs was observed mainly in improved efficiency, and enhanced safety and quality of care. Based on the above, a logic model for implementing the eMAR system in LTCFs was developed. Discussion: Adopting eMARs is highly resources consuming and the benefits in supporting staff and improving quality of care can only be realized with appropriate implementation, precise execution, regular evaluation and responsive adjustment. For this, the proposed logic model framework serves as a roadmap for LTCFs, both current and future users of eMARs. Keywords: electronic medication administration records, quality of care, long-term care facilities, logic model

背景：爲了改善居民的用藥安全，電子用藥記錄(eMARs)在長期護理機構中被廣泛採用。本研究的目的在於:(1)探討在長期護理機構中 eMARs 系統的使用現狀；(2)建立一個在長期護理機構中使用 eMARs 的邏輯模型;(3)探討與實際使用過程相關的關鍵情境因素。 方法：首先我們進行了一項文獻綜述，探討在長期護理機構中 eMARs 實施的現狀，主題包括其影響、障礙和挑戰，以及電子用藥記錄的使用率。第二，我們進行了一項利益相關者訪談。在 2021 年 2 月至 3 月，對 57 名有過澳門長期護理機構有相關使用 eMARs 經歷的關鍵利益相關者進行了深入、半結構化的訪談。 當中採用目的性抽樣進行招募，並根據邏輯模型的理論框架進行主題分析。 結果：大多數研究都集中在 eMAR 對護理質量的影響上。其中，對減少給藥過程中用藥差錯、改善效率和減少工作冗餘的效果被報導得最多。文獻報導的障礙和挑戰主要包括資金障礙及非資金障礙。在關鍵利益相關者的訪談中，所有 57 名參與者普遍對長期護理機構採用 eMAR 持積極態度。雖然財政資源例如獲得互聯網接入和採購硬件和軟件的足夠資金，均被認為很重要，但非財政資源例如高層承諾、從紙質基礎到 eMAR 的轉變過程以及培訓和交流，也被認為是重要的。主要採用的 eMAR 功能包括文檔、電子處方、提醒和管理的實 時監控。觀察到的最重要的產出包括簡化了給藥過程、減少了人工錯誤以及員工之間的及時溝通。觀察到採用 eMAR 的效果包括提高效率、提高護理的安全性和質量。在此基礎上，本研究建立了實施長期護理機構 eMAR 系統的邏輯模型。 結論：採用電子用藥記錄系統需要耗費大量資源，只有適當實施、準確執行、 定期評估、及時調整，才能實現對醫護人員的支持和護理質量的提高。爲此， 此研究建立的邏輯模型可作爲長期護理機構(包括 eMARs 系統的當前用戶和未來用戶)的路線圖。 關鍵詞：電子用藥記錄系統；護理質量；長期護理機構；邏輯模型