Computer documentation

  1. We will soon be going "LIVE" with computer documentation in our ICU. I am interested in how many other ICU's are using computer documentation and whether or not they like it. I have some concerns about the time involved in moving through the flowsheet. I realize that there will be a learning curve to using this system. I also would like to know what systems are being used out there, we will be using HBOC care manager.
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  2. 19 Comments

  3. by   BadBird
    I use computer charting at one hospital in the ICU, I prefer my paper flow charts because that is what I am used to but I am getting more comfortable with the computer. Most areas you just click the mouse on a preselected list of symptoms or observations, there are ways to enter free flow notes which I do quite frequently. Since I am agency I have to go with the flow and just try to do my best. What I like about the computer charting is that the I&O is always totaled.
  4. by   suetje
    When you say you will be using HBOC Care Manager' do you know who offers this system? Siemens? Hewlett Packard? Someone else? We are also getting into this area hospital-wide, and I as well would like to hear from any people who are doing this.
  5. by   nec
    i work in a msicu without computers, there is rumor though that they will be starting to overtake our unit in the future, i am sure it is the wave of the future, another thing every nurse have to start thinking change is good don't fight it roll with it!!! nec :roll
  6. by   RNforLongTime
    In my ICU, all of our charting is computerized. We use the Carevue system. Our monitors are Hewlett Packard and the data from the monitor is synched in with the computer, so all we ahve to do is click on the screen and the info pops right up for us. It's great! I love it!
  7. by   suetje
    When you use Carevue, and need to give many units of PRBC's, it is easy? Is it labor-intensive? We are looking at systems, and some are very tedious. You know if you have a pt. bleeding a lot, you have to be able to log in your blood without being at the computer the whole time. Any inof on systems other than Care-vue is welcomed. I believe the computer way is the way to go.
  8. by   Sally_ICURN
    Originally posted by suetje
    When you use Carevue, and need to give many units of PRBC's, it is easy? Is it labor-intensive?
    I use CareVue.

    My biggest complaint about charting blood products when giving a lot of them at a time is that we double chart vital signs and I think it's a waste of time.

    For example, after checking id, unit #, etc., with another RN, we write VS on the sheet of paper that comes from the lab with the unit and then we recheck VS 15 minutes after the infusion begins (unless, of course, we're using a rapid infuser or pushing it in by squeezing the bulb or using a pressure bag).

    Writing the VS on the paper is what I think is a waste of time because CareVue interfaces with our HP monitors and our urometers. We could more easily and quickly chart the vitals on the computer with a few pushes of the enter key. If there's a swan or a temp probe on the foley, the temp transfers to the flowsheet on the computer as well. Most people do both. I don't know why we can't just make a note on the paper from the lab stating "see CareVue flowsheet for VS?"

    The good thing about CareVue in this situation is that if you're really busy giving units really fast and you miss the 15 minute or even the initial VS, you can go back and pull up the vitals on the computer to enter them on the sheet of paper when you have a bit more time.

    Other than that, the pulldown entry options on CareVue are extremely user friendly and the "remark" option gives the RN an opportunity to enter notes not available in the pull downs. It's also very very good for looking at trends or finding information from previous shifts very quickly. AND (and this is important to me), you don't have to deal with terrible handwriting!!!!!!

    ~Sally
  9. by   suetje
    Thanks so much! It takes a user to see what is best. I may be iunvolved with choosing a vendor for computer charting and I want to be able to have some info into what works well.
  10. by   OzNurse69
    Originally posted by Sally_ICURN
    I use CareVue.

    Writing the VS on the paper is what I think is a waste of time because CareVue interfaces with our HP monitors and our urometers. We could more easily and quickly chart the vitals on the computer with a few pushes of the enter key. If there's a swan or a temp probe on the foley, the temp transfers to the flowsheet on the computer as well. Most people do both. I don't know why we can't just make a note on the paper from the lab stating "see CareVue flowsheet for VS?" ~Sally
    Sally, does CareVue not have a facility for printing off individual facets of care (eg v/s, progress notes, etc.) The computer programs I have seen do (sorry, can't give you any specific eg's as I work agency & don't know them all by name!) If it does, would it not be possible to print off the relevant obs, sign the sheet & attach it to the lab sheet?? Just a thought....

    Ruth
  11. by   countrylifeRN
    I have used HBOC charting and found it to be old and outdated. It's "F" key driven and slow. I can't believe hospitals are still using it. There are so many better computer charting systems. I'm sorry you're getting stuck with this one.
  12. by   dizzybee
    Computer charting is the way to go. Learning the system and training is hard, keeping a positive attitude is important.

    Make sure there is an adequate way to give your feedback on the system after it is implemented. Our unit educator set up a way for us to write down our problems that were not answered by our "super users" of the system (Epic is the name of the program). We found that the system was designed more for acute care, and not ICU. The educators for the ICU's are working with the software developers to make templates that work for our needs, which will be better! We found we were double charting in places, or if a graph or template were created for a specific area it would be helpful. Such as, it would be nice to see blood sugar numbers next to the rate the insulin gtt has been running at.
  13. by   ICUNurseCline
    I use powerchart. It took a while to get used to it, but now that I have, I love it. I think it provides better continuity of care across all disciplines. I agree with a previous response: CHANGE IS GOOD. Not only that, but the ONLY constant in health care is change. Accept it, encourage others to, and try to look at the positives!
  14. by   stressgal
    I too agree change is good and computerized charting is here. We use meditech, not all processes are the best and it doesn't always flow the best but it's what we have. "New/younger" nurses have few problems with the computer charting issue, "seasoned/older" nurses at times struggle and face challenges with it. I have found it easier to work with IS and our informatics director than to fight against it. Best to be a champion for change.

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