EPIC Computer Program - page 2
Hi, Does anyone's hospital use the EPIC system for charting? Our hospital is going to this system this month, and I am really interested in how other nurses feel about it. For me, it is very... Read More
0Feb 9, '08 by al7139Wow,
I am glad of all your responses. I am continuing to practice, and suprisingly enough, other nurses I work with tell me they think I will have no problem with the change and that I seem confident...I guess I am really good at hiding my true feelings.
I too am worried about the possible danger to the patient, the "real time" charting issue, and the fact that nobody I have talked to from MD to housekeeping feels fully competent with the system. We have had minimal class time, and the "refresher course" was a joke. We have yet to hear how we will determine when to do a procedure (i.e. dressing change q3days), and where we look to see what needs to be done. Meds are made more complicated by this system in my opinion, and it seems like we need to check the pts charts frequently to determine new orders, etc. also retroactive charting is more difficult, and my unit supervisor has stated that from day one we should not be using pen and paper to remember what to document, and what to do, and that anyone caught doing so will be reprimanded.
I am so scared that I will miss the important things because I have my nose in a computer screen. I am also afraid that patient care and customer service will suffer as a result.
Also "down time" sounds like a major problem.
I hope it gets easier, but right now, I don't look forward to it.
1Feb 19, '08 by aal5325My hospital went to the Epic System in September '07. Accodring to the company, this was the largest system they had ever done. We switched the entire hospital in one nine. We spent most of the summer arranging traing classes. Everyone recieved 24 hrs of training for the new system. What I can tell you is there are good points and bad points and it takes a while to get used to. Our ER doctors usually input their own orders, unfortunately, we have found out that the system tends to make it very easy to put an order in erroniusly on a wrong pt. Bestthing I can say is know your pt and the Dr writing the order and ask if you have a question about it. The system is an open software system, so itis designed specifically to a hospital's needs. It tends to limit the freehand notes, which I don't really like and certain procedures, such as conscious sedation, restraint logs, etc. really suck to use. No other way to put it. Some things really should be kept long hand. Now if you have Dr.s associated with the hospital using the same program, it can really be nice. The entire pts chart is on the computer. Allergies, meds, medical history, all available.
Give it a few months, you'll adapt and it won't be all that bad. Who knows, you may really like it.
Sorry about the extended post
0Apr 25, '08 by Needa Nursei am now sitting in a session where i am supposed to be entering orders for epic conversion. the whole teaching facility here in palo alto will change over tonight at mn. it is a little bumpy. hopefully, the whole changeover of the hospital will be smooth, and this system will be better than the system it replaces. :typingall md must place orders in the computer. many of the housestaff will have laptops to enter the orders, so no more verbals.
0Apr 26, '08 by medsurgrncoQuote from al7139I couldn't do my job without pen/paper. This looks like a setup for forgetting stuff and making errors. Do they expect you to document everything as you go, and still get everything done timely? Does Epic have a notepad option so that you can use the computer to help you remember stuff that needs to be done?and my unit supervisor has stated that from day one we should not be using pen and paper to remember what to document, and what to do, and that anyone caught doing so will be reprimanded.
1Apr 26, '08 by kcalohagirlWe're using a variation of epic.
It was a distinct change from paper charting. I miss paper charting a LOT at times. And there are a lot of times that you feel that you are double and triple charting.
With paper charting we did one full assessment each shift, then even when we did a smaller, more focused assessment, we wrote a note about it. Now, we have to go through the whole process 3 times each shift.
It can get frustrating. But as you work with the system more frequently, you learn how to make it more user-friendly. I miss the fact that our residents and PAs could look at the 24 hour flowsheet and see exactly what was happening with the patient.
Sometimes it seems that we spend half our time educating residents how to access the various functions in the electronic chart so that they are not asking the nurses redundant questions.
I have to believe it will get better. It seems the nursing service has reacted well to the new form of charting. It feels that many times, we are forced to educate the docs on how to access the information under the new system. And that can get frustrating for anyone
1Jul 3, '08 by al7139Hi all!
Just an update on my original post. First, thanks to all of those that replied to my thread, and especially those who gave positive feedback to reassure me. We have been "live" for 4 months now. The first shift I worked with it was really scary, and not fun at all. We were all terrified, and I felt like I had been thrown to the wolves. The training classes did not in any way prepare me for the reality of it. we had issues with the communication between our pyxys machines and epic which made getting meds very difficult, and with finding orders, where to chart, etc. Heaven forbid a pt had an emergency that required documentation!!!
We had to figure out what needed to be done on our shift (IV rotation, dressing changes, turning etc.) on our own, not from a schedule. This system is based on critical thinking and BPG's rather than a kardex that tells you when to do something. You really have to know the patients orders, and what you need to do, and it requires you to know the protocols for assessment, and to verify your nursing care. You also really need to be able to document as you go.
At first I really hated it, but as time goes by, I understand what the advantages are. We had IT people on the unit for the first month to help us, and were able to have a voice in how to "tweak" the programs to our advantage.
The system is not perfect, BUT for things like giving meds, I love it!
I believe it really cuts down on errors (like giving a 1/2 tab of something) since it alerts you to what to give. You still have to be alert to orders that do not make sense for your pt, but we did that anyway.
I also like that we can bring a unit into a pts room, and do an admission or a discharge right there. We can look up results of labs, vitals etc. to answer questions, and we can chart as we go. It did take some getting used to.
I have found some issues, but I have brougt my concerns to mgt, and they are being addressed (a biggie is releasing pended orders, I have found orders that were entered at admission days after the pt got there!). I also have found MD entered orders that are not correct, or need to be "fixed". They are very new to order entry. Also I have found that you have to look at orders carefully as far as date goes, because a conflicting order may exist since the original order was not deleted.
We are soon to omit written orders alogether...Yet another scary part of the process, but we will be fine.
I don't hate it anymore most of the time.
0Oct 10, '08 by FireStarterRNHi, just wanted to revive this thread. I'm going to be working as an agency nurse for a hospital system that is currently making the change over to epic and I went to the agency nurse orientation for it. The fellow doing the orientation said that the staff there is going through "the anger stage" right now in adjusting to the system.
I can see that it has positive potential in some respects, but is complicated in others. I'll have to start using it to feel comfortable.
1Apr 9, '09 by PaednochEPIC is successful if the Hospital that purchases it has good management. If management is detached and clueless then EPIC can be an EPIC disaster. Our hospital has been implementing epic of 28 months. ALL bedside staff are REQUIRED 24 hours of EPIC training PRIOR to "go Live". Hospitals that just "buy" the system and think the IT staff can teach people how to use it will have HUGE problems. If a hospital doesn't have a competent IT staff (very competent) then it will be very problematic. Hospitals MUST upgrade their IT servers and hardware space to accomodate EPIC. EPIC is a MASSIVE system that requires lots of computer horsepower to run. Freezing up is evidence that IT is not working. ALos EPIC is a physician based system. My hospital is going to limit verbal orders for Doctors to FORCE them to enter their own orders. It worked at Johns Hopkins it will work at our place. Our Hospital is 1000 beds and is University based so we will be transferring 158 years of medical records into the system. Last I heard it was over 10 million medical files. I do know my hospital system spend nearly a million dollars to upgrade the It Hardware system. If your hospital is having problems with EPIC freezing up...then you got problems with management being incompetent at understanding the modern medical world.
0Apr 9, '09 by PaednochTHose of you who are claiming of taking training a few days before changeover have extremely incompetent management staff. It took Johns Hopkins 10 years to implement the system. I work at the largest teaching hospital in the country and EPIC has taken 28 months to train everyone.
0Apr 25, '09 by trebugRNHi,
Just completed Epic training (our hospital will go-Live May 30th, had 12 hrs of training...hmmm, not enough?
For those of you that are using Epic already, I have a question. I work on a Renal unit, in training I didn't notice anything about PD caths, HD caths, stuff in care plans specific to new Renal Transplants?