Operating room charges

Specialties Operating Room

Published

Has anyone had to incorporate doing OR charges as part of their computer nursing charting?

This extra work will soon become mandatory and many of us are concerned about the additional time it will take to do this and the effect on room turnover times.

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Specializes in MedSurg (Ortho), OR.

Hi,

My OR is doing charges on our online system.

I don't know how your system works, but our system, we have asked the IT people to have a drop down selection of doctors on our screens.

So, for instance Dr. Feelgood uses 3 Prolene, 6 PDS, ESU, flowtron, thrombin etc etc.... we can just select that and poof all his preferences are charted. It is just our jobs now to just make sure to delete what ever he didn't use and update his preferences if he does change what he likes.

There wasn't much time added to the turnover time, if you make sure you chart asap.

-Brian

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Specializes in O.R., ED, M/S.

We have been computer charting for years in the OR. Our charges are still still done by hand though. It only takes a few minutes to do charging because we aren't allowed to charge for such small items such as suture, dressings, etc... We have a room charge that alot of this is incorporated into. Most insurance companies will not allow payment on certain things so you just bury them into your room charge. They don't usually challenge this.

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Yes we do all charges on the computer. It does take extra time to have to put in implants though, especially when there are alot of different screws and plates. This is a royal pain in the butt.

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Specializes in Operating Room.

We do chart charges as part of the computer charting. After you learn what is used and what isn't, it really doesn't take that long at all. I'm still fairly new, so it still takes me time to think about it.

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We use computer charting, but paper charging. When we "pull" a case, we get a worksheet and a pick list with all the anticipated items. We indicate which items actually get used and manually add any that are used but not on the list. Central processing uses this information too-- it includes things like instruments which we own, and they can keep track of how often the instruments get used.

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Specializes in OR, Nursing Professional Development.

In our OR computer system, the surgeon's preference card is automatically charged for, and we're just responsible for implants and anything that gets added. That being said, if it's a big trauma case or a ruptured AAA, I'm not too worried about charging for every little hemoclip cartridge or suture added. On those cases, about the only charge I worry about adding is the implant, and that's mostly because if it's documented as an implant but not billed for, the charges come back for correction- sometimes up to a year later.

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Thanks all for answering my inquiry as to OR charges...

I think the "normal" usage charges will be a snap, its just the larger items and expensive things like implants that will be the most challenging. My hospital is using the Meditech system and it is not user friendly or updated. Items are hard to find and may not even be in the system. I wish they would just get a windows based system that is easier to use!

They took this job away from a tech that was trained to do charges and that was all he did....dont know the rational for having the nurses do them????

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Specializes in surgical, emergency.

We are in the process of changing over from paper to computer.

We are using a system from McKession (sp?).

A couple of our nurses, OR and PACU primarily, went away to pick the programs, and help modify it to our needs.

We've also been incorporating the computer system in steps.

Scheduling, charges and basic charting, then moving on from there.

Our chart consists of the "chart" portion , pt name, procedure, etc, then the charges.

A charge section has anes. charges and our stuff. Packs, sutures, instruments, etc.

A printed version of this is run off the day before and used to pull the case.

Our inventory control person checks over our charges the next day. This program also helps with our inventory.

Sometimes I'm OK with the system, other times....not so much. Little glitches, and down times are a problem. I use the "pull sheet" some, when I can't finsh, fast case, lots of implants, etc, I'll write notes on the sheet, and enter the info later

Each RN circulator has our own laptop, that helps too.

I think it'll be easier when we make the break from paper completely. Right now, we are doing some of each.

Mike

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