Kardex ?

[nursecompassion]

I'm a new grad and am working on a med/surg floor which is having difficulty with staff not reading the kardex's and missing orders, data, etc. Where does your unit keep your Kardex? Where I precepted at spring quarter they were kept with the pt MAR, which seems to me like a great idea for where I'm working now. What do you think?

[Bella36RN]

Our hospital no longer uses a kardex because diets etc. would not get changed and nurses relied on it to heavily....i say go to the order

[mscsrjhm]

Everything we have is on the computer. We get printed out MARs, and Patient Care summaries, which have the pt's dx, hx, allergies, code status, fall risk and mobility status, IV site, and all orders, including diet, meds, etc.

I have used these also at some facilities. We generally termed them Kardex', as it covered everything the old Kardex covered, plus some.

My question is, for those who do not use Kardex, whether pencilled or computer, how do they give report and get their information quickly at the beginning of the shift?

Do they have another method? Or do they just rely on report?

[not now, RN]

I have used these also at some facilities. We generally termed them Kardex', as it covered everything the old Kardex covered, plus some.

My question is, for those who do not use Kardex, whether pencilled or computer, how do they give report and get their information quickly at the beginning of the shift?

Do they have another method? Or do they just rely on report?

We go over everything in report. My hospital was supposed to phase out Rand cards years ago but med/surg is clinging on to them for dear life. When I worked med/surg/ortho I didn't know this, then I transferred over to ICCU and found out from the NM. When a nurse floats over to us they tend to get a look of shock when I say "Oh, we don't use Rand cards..."

My school did clinical in a hospital that was all paper charting. Hoping that the Kardex was up to date was gamble and I'd end up rummaging through the chart anyway. At this hospital the info is so easy to look up on the computer and I know it's up to date.

[spider11]

We don't use Kardex either. We give verbal report to oncoming/outgoing shifts. IV charting, diet orders, etc are on the computer.

[husker_rn, RN]

Last hospital I worked in had 2 copies; one with the MAR and one in a book with the unit secretary. Nursing got a copy of all orders and updated the nursing copy; noc shift made sure all changes got made on the nursing copy. Double entries but it worked.

[chenoaspirit, ASN, RN]

Our Kardexes are kept in a 3 ring binder. They are kept up to date, its very important so that when we take the book into report, we have up-to-date info on each patient. As orders are taken off, they are added to the Kardex. The computer report sounds awesome though. I wish we had something like that. But we still use paper charting. We are soo out of date!

[Sunflowerinsc, ADN, RN]

Without a kardex, how is general information passed?

I have worked at only one facility that did not have Kardex, and we received no information during report. Other departments were not happy with the lack of communication, teaching wasn't done because no one knew about it, IV sites without dates, not charted in nn.

The information that I am concerned about is diagnosis, history, orientation, mobility status, teaching needed, diet, dates of IVs and dressings, etc. If it is not passed on in report- no way of knowing.

How do you communicate basic information at the beginning of a shift? There is no way that I would have time to check all charts and review all orders at the beginning of a shift (and sometimes throughout the shift).

What do you use instead?

I have not seen a Kardex for years and years. We use our pt care worksheets that are computer generated from the information entered on each pt per care plan, Dr. orders. They have all the interventions from the care plans, the standard interventions such as Vital signs ,weight ,diet ,daily assessment. And the interventions from the medical diagnoses. Like the Iv 's,dressing changes and any other orders. These show up every time a new order (dr or nursing ) is put in. This, I guess is the closest to the old Kardex information. The worksheet has the history,diagnosis ,teaching needs, flu and pneumonia and other core measures.

Our verbal shift report is on voice care (phone) and history, code status ,Dx is entered on each pt on admission . The report is given of course, on each shift and some people tell you when IV needs changed, dressing due ,ect but some don't do that as that information is on your worksheet and the lest your repeat , the shorter the report .

Sorry this turned out to be long and I hope it is clear.