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- Apr 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
- Jul 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.
- Oct 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.
- Apr 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.
- Apr 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.
- Apr 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?
- Apr 25, '09 by FlyingScotWe are switching over to Epic in an ambulatory setting. We are getting a total of 6 count 'em 6 hours of training on this behemoth. I've worked with 4 other programs and this is by far the most cumbersome ever. I all ready know which one of our nurses will never get it and which one is going to cry and have a melt-down when she can't figure it out. Not to mention the PTB are rolling it out the first week of July (hello..med students who have magically turned into residents overnight time). One of my friends is scheduled to go on vacation, she's all ready chortling with glee!
- Apr 25, '09 by suannaBE THANKFUL. Computer charting is becoming the standard everywhere. Even though I have no experience with EPIC, my hospital went with a different program -- what a nightmare! Several of the nurses I work with have used EPIC at another hospital in the area and LOVE it compaired to what we got stuck with. Like anything else- there is a learning curve. Even with a poorly designed system- once you get it down, patient care is still what you spend your time with.
- Apr 26, '09 by trebugRNHi Epic users,
(thought I posted this Friday, but I don't see it anywhere - pardon me if it's hiding out there somewhere!)
We are going live with Epic soon. I work in a Pediatric hospital on a Renal floor. Wondering a few things about items I couldn't find during training:
Place to chart fistuals but nowhere to chart Hemodialysis catheters or peritoneal dialysis caths.
Careplan for kidney transplant/dialysis pt's.
- Apr 26, '09 by al7139Hi again!
I posted this thread originally last year prior to our hospitals "Go Live" date. I have to say that the hospital and the IT people have been really great. We even have a committee of floor nurses from all units who meet regularly with Mgt and IT to improve the system.
I have really changed my opinion and even helped out my sister hospitals (there are 7 in the system) as a "Superuser" when they went live.
Now, I love the system, and I recently picked up a shift at one hospital that had not yet made the change, and was still using paper charts, and hated it.
I am all for the EPIC program now, and recommend it to any hospital, but they have to tweak it to what works for them.