Safety of Electronic Documentation - page 2
by herring_RN 4,406 Views | 13 Comments Guide
Are nurses and others at your facility acting to ensure the safety of computer systems? This article gives personal and facility examples of safety issues.... Read More
- 0Jul 12, '13 by ♪♫ in my ♥I guess it's wait-and-see.
I used NextGen (lousy) and HMS (beyond horrible) before moving to Epic.
That my hospitals were duped into buying either of the first two is a sad testament to how woefully unprepared are many smaller facilities to undertake tech acquisition projects.
Epic, while having its issues, is actually a useful tool that enhances patient care rather than detracting from it.
- 0Jul 13, '13 by herring_RN GuideIt seems to me that many of the problems are due to lack of preparation and training. I also think additional staff should be scheduled until the staff and physicians are competent in the use of the system.
I quoted part of an article:
In over 100 reports submitted by RNs at Alta Bates Summit Medical Center facilities in Berkeley and Oakland, nurses cited a variety of serious problems with the new system, known as Epic. The reports are in union forms RNs submit to management documenting assignments they believe to be unsafe.
Patient care concerns included computerized delays in timely administration of medications and contact with physicians, ability to properly monitor patients, and other delays in treatment.
Many noted that the excessive amount of time required to interact with the computer system, inputting and accessing data, sharply cuts down on time they can spend with patients with frequent complaints from patients about not seeing their RN.
"EPIC is a system that is so cumbersome to use for nurses and physicians, that we often feel as though we are caring for a computer, not a patient,” said Thorild Urdal, an RN at Alta Bates Summit’s hospital in Berkeley. “It delays care and treatment, the program is naturally counter-intuitive and it was clearly not designed in concert with nurses and physicians." ...
... At Alta Bates Summit specific incidents directly related to Epic problems included:
- A patient who had to be transferred to the intensive care unit due to delays in care caused by the computer.
- A nurse who was not able to obtain needed blood for an emergent medical emergency.
- Insulin orders set erroneously by the software.
- Missed orders for lab tests for newborn babies and an inability for RNs to spend time teaching new mothers how to properly breast feed babies before patient discharge.
- Lab tests not done in a timely manner.
- Frequent short staffing caused by time RNs have to spend with the computers.
- Orders incorrectly entered by physicians requiring the RNs to track down the physician before tests can be done or medication ordered.
- Discrepancies between the Epic computers and the computers that dispense medications causing errors with medication labels and delays in administering medications.
- Patient information, including vital signs, missing in the computer software.
- An inability to accurately chart specific patient needs or conditions because of pre-determined responses by the computer software.
- Multiple problems with RN fatigue because of time required by the computers and an inability to take rest breaks as a result.
- Inadequate RN training and orientation. ...
- 0Apr 2 by losbozosMy problem w/ Epic is when the PCP does write new orders (all PCPs do it electronically), I have no way of knowing unless I seek that info. I've had docs put in orders from home in the middle of the night w/o my knowledge. I believe the designers of Epic think we sit around at the computer while at work. Hello???? This is not an office job!
- 2Apr 2 by dudette10Quote from losbozosSerious question: how is that different from paper? Although I've been at this for only 2.5 years, I was in a paper environment for about a year. If that little yellow tab wasn't sticking up and the chart wasn't placed on its side in the rack, I didn't know that a doc had entered an order either. I have my issues with CPOE--primarily orders entered incorrectly that nursing MUST be knowledgeable enough to catch for patient safety reasons--but I believe your issue with CPOE isn't unique to CPOE.My problem w/ Epic is when the PCP does write new orders (all PCPs do it electronically), I have no way of knowing unless I seek that info. I've had docs put in orders from home in the middle of the night w/o my knowledge. I believe the designers of Epic think we sit around at the computer while at work. Hello???? This is not an office job!