Tell us about your computer system - page 3

If you have Computer Charting at your job, please start a new topic in this category. Tell us if you like it, or hate it. Enjoy! ------------------ Brian Short WORLDWIDE NURSE: The... Read More

  1. by   matsu
    I work in a homehealth setting using a portable computer-we import and export all of our patient notes each day either from home or from the office-it makes charting itself quicker but we still have to followup with signing each piece of paper generated-admits generate approximately 13-14 pages-editing thepathways seems to take quite abit of time-in general the system works well
  2. by   Cheryl DesRuisseaux
    Hi Brian,
    I work in an operating room and am interested to hear from any other OR Nurses that might be doing intraoperative computer charting.How does that work?
    Cheryl D

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  3. by   nancyR
    Originally posted by bshort:
    If you have Computer Charting at your job, please start a new topic in this category. Tell us if you like it, or hate it.

    Enjoy!

    Brian, have you done a tally on which systems are preferred and why? Which to avoid and why? would be interested in that info.
  4. by   JenRN
    Hi! I work at a large hospital (500+ beds). I am an RN Clinical Analyst for our informatics system. The product we use is Ulticare.
    Unlike many hospitals we have heard from, we chose to "go-live" in phases. Our phase I included simple navagational information and basic order entry. Ancillary areas were more on-line than nursing, due to the standardization of documentation (ie lab results).
    Phase II began just last year when we began to bring units sharing a common bed type live with nursing documentation at the bedside. It is true that no matter how hard you test something, you will always find somewhere to improve once it is put into practice! Thus, our job is to continue to maintain and support what we have already built in addition to what we are currently building. We are lucky in respect that our vendor for Ulticare continues to support us!
    I must say that to begin with, the nurses on the floors going live cursed us and the system for at least a month. We understood and provided 24 hour on the unit support for two weeks after go-live. After becoming more proficient and confident, the nurses learned that bedside electronic documentation enabled them to spend more time with their patients, view orders and results from a "queue" designed just for them, and they actually got to go home on time!
    There are problems as well. Some staff members do not like the system and are adamant that they never will. Certain physicians are writting orders to print the chart thus creating a paper trail and basically defeating the purpose of the system. Also, there are some things that a computer just can't do. It can never replace nursing judgement. The computer will show you what has been entered into it and that is all. I have seen some staff members accept a final review of abnormal information as if they were zombies. We teach them to USE the information they see and act accordingly. Accepting an abnormal lab value does nothing for the patient.
    Okay. Maybe this has been too much information. Just let it be said that JenRN loves the work she does and looks forward to advancing her career in informatics. That should say it all.
  5. by   memory
    I work in an office of 3 family practice physicians. All of our patient charts are on computer. Lab results, telephone messages, vital signs, etc..Our receptionists "click" on the patient's name on our electronic "schedule" to let the nurse at her station know that the patient is in "Lobby, wait Lpn" that is where it all begins.
    I have been in this office since it opened 2 years ago, some of the electronic charting is much quicker, some is redundant... We receive lab results, we must then enter the information from the paper to the computer, instead of just filing after reporting to physician...We do still have "paper charts". Even our physicians carry around their own personal "PEN units", which basically is their own little lap top, that has every patient's chart information in it. So when the doctor is in the room with the patient, the chart, lab, x-ray, vitals, previous visits, Dx, Medications are just a click away... It is actually pretty cool...
  6. by   MED/SURG NURSE
    We also have had Meditech for 2 1/2 yrs. Many good features, and we are still learning ways to customize our programs. One area we are trying to figure out now, is how can LPN's document assessments and notes within their scope of practice? Before with paper charting, the RN's would co-sign LPN's documentation, but that is not possible with our Meditech system. If anyone out there uses LPN's in the acute
    hospital setting, how or do you have them document on Meditech within the "Rules"?
    Originally posted by JJC:
    The hospital that I work at has been using the meditech computer charting for about 2 years now. We use handheld computers as well as PC's that are at the nursing station. At first it seemed time consuming, but now I can't imagine going back to paper & pen documentation. I work in an 8 bed CCU/ICU and we recently installed an interface which allows vital signs/o2 sats etc to cross over into the main computer which saves even more time as we don't have to individually enter them. One draw back to this form of documentation is that if your facility uses registry nurses it breaks up the continuity of the documentation as they use pen and paper charting. I also don't care for the I&O
    on our system as it puts it in 8hour time periods and you can't look back and see a patients hourly output. Everyone I have talked to prefers the computer documentation over paper!
  7. by   Mary H.
    I was part of several Meditech implementation teams at my prior facilty. LPNs in NM could assist with data collection and deliver care, chart what they do. Our entire paper system and our Meditech was set up to require only RNs to complete portions of the initial assessment and the plan of care. We never had a problem passing survey. There was a Meditech feature that would allow amendments to the Patient Care notes. You could have the RN amend the LPNs notes if you have to show a cosignature for any reason. I have not worked in WI for many years, but I don't remember having to cosign for LPNs when I did.
  8. by   crobar
    I work in a 300 bed hospital. We are in the middle of a 3 year project with Cerner. The triage portion, FirstNet went live 2 months ago. PowerChart (documentation, or at least some of it) went up 1 month ago and SurgiNet next week (Periop documentation and scheduling). The lab is on the system and the ICUs (INet, naturally) and Orderentry (CareNet) right after Labor Day. It was dreaded by most but the Cerner support has been great and IS and I have been "Live" with the Staff for from 1-2 weeks during and following "Go Live". It is amazing how much everyone likes it now and how much we whine when the system goes down. There have been glitches, of course, but they have been speedily addressed. We use both "fat" and "thin" clients but no handhelds (too easy for them to walk). A smaller hospital that is part of our system is going to use flat screens in the OR. Documenting is much faster and is much clearer than by hand. Sorry to go on for so long but, as you can tell, I'm a fan of Cerner.
  9. by   Nancy Nurse 2000
    I work in a small hospital (50) beds, and we use the CPSI computer system throughout also, except nursing. We have never gotten the phase which includes the charting for nursing. However the fact that we can pull up labs, x-rays, etc makes it nice for us! Maybe someday soon we can get the charting. We are still slaving over narrative long hand!

    Originally posted by Sister:
    I work in a small hospital (113 beds), one of the few in the USA with the same system throughout;our business office, nursing, supply, etc. is all same system. We use CPSI
    Point of Care. Not a bad system, but plenty of room for improvement. We have been doing this for about 5 years, continually improving. I have learned that nurses do like to chart a lot(in case of lawsuits! I think), but waste much time. Charting by exception is good, the important thing is to have a system that is adaptable to your environment. Would be interested in hearing from anyone else using CPSI, want to network to improve our usage.
  10. by   lv an rn
    Originally posted by bshort:
    If you have Computer Charting at your job, please start a new topic in this category. Tell us if you like it, or hate it.

    Enjoy!

  11. by   lv an rn
    Originally posted by bshort:
    If you have Computer Charting at your job, please start a new topic in this category. Tell us if you like it, or hate it.

    Enjoy!

    Our facility recently went to computerized charting and there are LOTS of problems. The biggest problem is admissions----it takes at least 45-50 minutes because there are so many screens to go through. Many of the screens don't apply to our med-surg patients, it's very frustrating. The other is the amount of paper waste, it's shameful. At the rate the hospital is going through paper, my grandchildren may not know what a tree is when they grow up!!!!

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    Susie
  12. by   HazeK
    Our 30 bed, high-risk L&D unit went to computerized fetal monitoring over 10 years ago........then, we added "event documentation on the computer strip" (like, meds given, VE, repositioning, etc........then we added our nurses' bedside notes (like the q30" documentation during an induction of FHR, patterns, uterine activity, etc.)
    .......... then, we finished up adding all our other charting onto the computers, like meds, PACU records, I&O shift totals, etc. All these additions were done over the course of the following 5 years. Everyone who thought they would hate it (us 'old' nurses who weren't "computer-literate") would NEVER want to do without again!

    The system (Corometrics/Marquette/ QMI) is designed by OUR nurses for OUR unit to meet OUR needs...and that is why it works!!! It is not designed by 'geeks' who don't work at the bedside! Also, we have a full PC system at EACH bedside!!!
    The idea of computerized nursing documentation MUST include PCs at each bedside... because of that very basic NURSING 101 class: you chart it when you do it/see it, etc......NOT back-charting at the nursing station when you have computer time! Try it....you'll like it!!!

    Personally, I'm 49...& a nurse for >26 years....& I plan to practice at least until we have small microphones clipped to our uniforms, where I push a button, dictate a note specific for that patient & the voice-recognition program on the nurses' station computer types out my shift notes for me to review & sign at the end of the shift!!!

    see ya then! Haze
  13. by   BROWN_KK
    I came from paper charting then to computer charting and now back to reams of paper charting. We used the carevue system with vital signs and u.o. being defaulted over to the bedside computer. The drips were calculated, the assessments complete and the charting overall very comprehensive. Plus you could compare labs and trend vital signs. Cannot be beat for thorough charting in this age of very complicated and technological patient care.

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