[abooker]

All of my residents are dehydrated.

They’re eating and drinking normally, their skin turgor feels good, and their urine looks straw-colored, but they’re all dehydrated. I would never have known this if it weren’t for our new electronic charting system.

Although we’ve only been using it for two or three weeks, I’m already seeing tremendous improvements in my delivery of care. How otherwise would I know to push fluids and hold furosemide?

If some of my residents start to cough and I hear crackles and wheezes in their lungs, I guess I’ll be asking for chest x-rays? Maybe sending people out? I guess this will decrease medical errors by lowering the census and giving me more time per resident.

I don’t see how our new system will help lower health care costs. Anybody have any insight into this?

[rninformatics]

Healthcare costs are lowered when patients are treated in a more timely and cost effective manner. When quality care is delivered and patient outcomes improved studies have shown us that costs are decreased.
Research shows that medical errors,patient injury and often patient deaths can be decreased and avoided by the use of CPOE, electronic documentation, decision support systems, drug interaction alerts, eMARs and bar code medication administration systems.
When data is collected (from electronic documentation systems, results reporting systems, point of care diagnostic testing equipment, electronic vital sign monitors, etc) and synthesized into information and then that information is in turn utilized by clinicans as knowledge to diagnosis and treat patients -- that is how systems help to lower health care costs.

Originally Posted by abooker

All of my residents are dehydrated.
I don’t see how our new system will help lower health care costs. Anybody have any insight into this?

[abooker]

Quality care seems to involve ignoring the information being compiled by the electronic chart. I don't know ... should I ask CNAs to avoid charting inputs and outputs, or should I continue to ignore the messages alerting me to dehydration, or ... ?

The only knowledge I seem to be deriving from the info provided by our new system is that I should question the information received. I'm not yet finding it useful as a clinical tool. Does this come with time, or is there something more proactive I could be doing? I'm in long term care. Looks like the system was designed with a hospital in mind, and maybe that's why I'm having problems?

[rninformatics]

You first need to remember that information is only as good as the original data it was obtained from. GIGO - Garbage in, garbage out..........
IF the system is providing false alarms perhaps the indicators/alerts/alarms are set with incorrect parameters. Have you reported this to the appropriate people/depts at your organization? Instead of ignoring the message alerting you to what the system sees as a dehydrated pt have you proactively followed up with someone about this incorrect and false alarm? If my car beeps that my seat belt is not fastened or the "check engine" light keeps flashing even though I know my seat belt is fastened and I just had the car serviced. Its still my responsibility to report the problem to the dealer/mechanic.
Of course you should question the info received, you are still the human being - the system is only a tool to be used by you. The use of clinical systems does not eliminate the need for nursing judgement.
Good Luck!

Originally Posted by abooker

Quality care seems to involve ignoring the information being compiled by the electronic chart. I don't know ... should I ask CNAs to avoid charting inputs and outputs, or should I continue to ignore the messages alerting me to dehydration, or ... ?

The only knowledge I seem to be deriving from the info provided by our new system is that I should question the information received. I'm not yet finding it useful as a clinical tool. Does this come with time, or is there something more proactive I could be doing? I'm in long term care. Looks like the system was designed with a hospital in mind, and maybe that's why I'm having problems?