Computer charting-what do you think?

[RNperdiem]

This month my ICU will switch from paper flowsheets to computerized charting.

How many of you out there have made the switch to computer charting, and what do you think about it.

I admit I have a few reservations about it. I can quickly fill out the vitals, assessments,and other details with little effort on the flowsheet. The doctors can pick up the flowsheet and see 24 hours of details right there.

Did computerized charting make anything easier?

[GIRN]

I was so excited to get our computers....now I want my paper back. It is nice to be able to read the H & P's and see the labs and have all the vitals in a row....but having to input all this data takes us away from the bedside. I don't have time to talk to the patients anymore. The program we're using is not user-friendly....we have to go to so many screens to chart little pieces of information. It takes forever! It's very redundant and silly to have to double and triple chart the same pieces of info but different departments keep telling us..."if you don't do it here, we won't see it to charge for it...If you don't do it here, we won't see it to keep JCHACO happy...etc. etc. etc."

One other concern we have is that it's hard to tell what's chronologically been going on with that patient. And if three different nurses chart their info in three different places...you may completely miss something that happened. We're afraid that it'll be hell to try to defend ourselves in court if necessary, with the charts we're using now. We're told to chart by exception and not to use the Nurses Notes screen...but that's where we all want to go to narrate what's happening for the next nurse.

The answer is....I don't care for the computerized charting....at least not the program we're using. Though our hospital paid millions for the computer program, the computer company isn't in any rush at all to give us a program that's more user friendly.

[theatredork]

I personally think computer charting is great. I'll be the first one to admit that my handwriting is horrible, and luckily nobody has to deal with it because everything is computer-based charting. It's just nice to be able to always have access to a chart, and also be able to read text, rather than someone's scrawl.

[suanna]

The problem with the "bad software" argument is that it implies that nursing convenience is given any consideration when the budget for the software is set. Where I work if it only inconveniences the nurses and delays patient care it's not a problem. It has to cost more to be a problem. If I have to work twice as hard to do the same care it's OK, they still only pay me once. If I don't like it I can quit and let them hire a new grad an 1/2 my pay- another win for the hospital budget!

[Penguin67]

I like computer charting IF and ONLY IF the program is user friendly and information is easy to locate. Computer charting makes having the chart available to many different people at one possible. However, the local hospitals have computerized charting that is not user friendly, rather, they systems are very basic, and obviously not designed by nurses. The big issue that I have is that you never know if you finished or not, as there are so many places to chart the same thing. You might chart one place and another nurse uses a different place.

The only computerized charting system that I have ever liked was in Tuscaloosa, Alabama, at the VA Medical Center. They went paperless in the mid-90's and instead of the nightmare that I expected, it was so pleasant, becuase the system was created and managed by nurses, and the "chart" was similar in appearance to an actual chart. Once you entered the patient's name, the screen that appeared was a "face page" with admission info, and there were tabs all along the bottom of the screen, just like tabs in a paper chart. CLick on a tab, and you access that area of the chart. I could see pictures of xrays. Wahtever was still in paper form was scanned in, so we could also view consent forms, etc... What a beautiful system! And, all of the VA's used the same system, so when we sent a patient to Birmingham for treatment, they could access their computerized chart there, as well. I haven't seen anything that could match that computerized system.

But, as an older nurse, I have to admit that I long for the days of paper charting. It seems like charting was so much easier then. Computerrs, in my estimation, have done nothing but complicate the process of charting, instead of simplifying it as I thought computeres would.

[medsurgrnco, BSN, RN]

It depends a lot on the computer system, and if medication administration is also linked into the computer documentation versus paper charting. I just started working with my preceptor for my new job today, and discovered they expect me to drag around a computer cart all night so I can chart as I go! Like that's not gonna slow me down. I'm not a bag lady - I'm a nurse!