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Computer charting in L&D

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evltwnRN evltwnRN (New) New

Hey Everyone,

I am a L&D nurse for 15 years and I need some input. My unit has recently been computerized. I am also a student going for my APRN in Womens Health.

I am writting a paper on nursing and computers. Thats where the input comes in...

How big is your unit and what is your nurse patient ratio for the different stages? Not what is should be but what is REALLY is.

1. Do you have computer charting on your unit?

2.How do you feel about it?

3. What is your program like? Do you have multiple screens to do what was on one sheet of paper etc.?

4. Do you think it frees you up to give more individual time to the patient?

Any other comments or insight is welcome.

:p :p

We are lucky. We are an LDRP and we work 1:1 in labor. WE also flex and help each other in any area whenever the you-know-what hits the fan!

1. Do you have computer charting on your unit? yes, just for labor. Our system is old.

2.How do you feel about it? I wish it was more comprehensive. I hope they update.

3. What is your program like? Do you have multiple screens to do what was on one sheet of paper etc.?We have OBTraceVu. I do not recommend it.

4. Do you think it frees you up to give more individual time to the patient? N/A

The unit I currently am working in is not computerized with regard to patient charting and the like. We do use the computer to put in orders and such...The last place I worked we did hollister charting and were all very nervous when delivery went to computers. Much of that scariness I now think, was due to change and I have found that we nurses are not always great with change..Anyway, after the whole business got started and we became good at it, I discovered that my typing skills certainly increased, and it brought down my stress level somewhat because I could be in one room and see what was going on with the fetal heart in other rooms I couldn't be in. That way I always had the heads up if a decel or problem occurred in another room, and I could document on the fetal strip, which we did every fifteen minutes, anywhere I was. My current nurse manager doesn't want to spend the money for computerized monitors and says it is because it takes the nurse away from the patient. I actually found the opposite to be true..Everyone was much more vigilant and interested in the strips going across the screen. It did greatly decrease the amount of paper work and repetitive paperwork we had to do so we were able to spend that much more time with our patients..

SmilingBluEyes

Has 26 years experience.

We are phasing it in, here and there, and it's the PITS. We use meditech (a dinosaur system to be sure) and it saves NO time and uses MORE paper than old fashioned paper/pen charting ever could. Fortunately, no plans exist to do computerized charting for our labor patients, just PP, Newborn and GYN surgical. I think it's awful, and I am no technophobe, either.

I used to really love Hollister charting. To me it was so quick and easy. The computer program we use is Quantatative Sentinel. You can chart directly on the Fetal Heart Tracing but the other screens take forever. it would be great to just be able to chart everything right from the strip. Then when you need to find something like ROM you have to click through about 6 screens you can'tjust go to that one. There is no one screen that has all the info on it. The postpartum unit doesn't use the same program and they are not going to be. So when we transfer the patient we have to print out the entire chart. We use more paper now than we did when we used paper. :balloons: :angryfire :imbar

Oh my...meidtech for labor charting.. When we first went to computer charting, it was on this %$#%% system. We all had 1-2 hrs of charting at the end of our shift, and the overtime was killing the budget. So then they got "watchchild" which was ok and pretty easy to use, but the fda said it wasn't upgradable, so we went with QS which is much more of a windows application. hard to learn for some who weren't as computer literate. We use this for PP,Antes, and Level one nursery. By the way the rest of the hospital still uses meditech. Anyhoo, I think the computer has made our practice a little easier, with the prompts on certain screens and not having to repeat the admission questions for repeat admissions. I also like the no paper route now (gasp) who would of thunk it.

I live in a small town, we do about 20-30 births per month and are set up as LDRP. We went to computer charting last June for everything except ICU babies and bilibabies. We were all very apprehensive about it but truly it has gone very smoothly. I Really like it, especially for labor as it is faster for me to type than write. It isn't the best system in my opinion since you do have to click through a lot of screens, but once we got it figured out it's OK. We use Lastword. When we went to central monitoring about 5 years ago we thought it would take us away from the bedside but I don't think it's true, and now I can't imagine working without it truly.

tryingtomakeit, RN

Specializes in LTC, Home Health, L&D, Nsy, PP.

Hey Everyone,

I am a L&D nurse for 15 years and I need some input. My unit has recently been computerized. I am also a student going for my APRN in Womens Health.

I am writting a paper on nursing and computers. Thats where the input comes in...

How big is your unit and what is your nurse patient ratio for the different stages? Not what is should be but what is REALLY is.

1. Do you have computer charting on your unit?

2.How do you feel about it?

3. What is your program like? Do you have multiple screens to do what was on one sheet of paper etc.?

4. Do you think it frees you up to give more individual time to the patient?

Any other comments or insight is welcome.

:p :p

You have hit a nerve with me! lol

We are in the process of going from paper to computer. At first I though I would like doing computer charting, but now I am finding myself in the middle of one huge nightmare.

I work in a small hospital wich operates on a shoestring budget. There are usually two L&D nurses scheduled, but often only one and where we are lucky enough to have two nurses, if the patient load is light, one of them gets called off or reassigned to another area (and we all know how quickly a L&D can fill up!).

The problem is, during the transition time of us going to computer, we are having to do our charting on both the computer AND paper. We barely have enough time to do it in one place, much less two! We haven't gone live yet with our computer charting, we are still just kind of in a practice stage, but we are catching heck because we are sometimes not getting to the computer part. I AM AT MY WITTS END! :uhoh3:

tryingtomakeit, RN

Specializes in LTC, Home Health, L&D, Nsy, PP.

Hey Everyone,

I am a L&D nurse for 15 years and I need some input. My unit has recently been computerized. I am also a student going for my APRN in Womens Health.

I am writting a paper on nursing and computers. Thats where the input comes in...

How big is your unit and what is your nurse patient ratio for the different stages? Not what is should be but what is REALLY is.

1. Do you have computer charting on your unit?

2.How do you feel about it?

3. What is your program like? Do you have multiple screens to do what was on one sheet of paper etc.?

4. Do you think it frees you up to give more individual time to the patient?

Any other comments or insight is welcome.

:p :p

You have hit a nerve with me! lol

We are in the process of going from paper to computer. At first I though I would like doing computer charting, but now I am finding myself in the middle of one huge nightmare.

I work in a small hospital wich operates on a shoestring budget. There are usually two L&D nurses scheduled, but often only one and where we are lucky enough to have two nurses, if the patient load is light, one of them gets called off or reassigned to another area (and we all know how quickly a L&D can fill up!).

The problem is, during the transition time of us going to computer, we are having to do our charting on both the computer AND paper. We barely have enough time to do it in one place, much less two! We haven't gone live yet with our computer charting, we are still just kind of in a practice stage, but we are catching heck because we are sometimes not getting to the computer part. I AM AT MY WITTS END! :uhoh3:

OMG!! We initially had to do both too. Some of us almost quit. The L&D unit that I work on is supposed to staff 6 or 7 on days, 5 on eve and 5 on nights. Well reality is 5 on days, 4 on eve and 3 on nights with people on call. It was almost impossible to do both. I thought it would be better just to scrap the paper and jump right into the computer. Then you had to learn it and didn' t have a net (of paper) so to speak. It is 6 months since going live and we have Dr. that refuse to use the computer to chart, nurses who use paper in triage because the triage in the computer is way to long, nurses who skip over parts of the admission or don't do the admission because they don't like it. I would have to say many of us only like the point and click part of the Fetal Heart Tracing. The rest is just a pain. I used to work at a little hospital like that. They would staff 3 nurses, one in PP, one in the nursery, one in L&D. You could get floated out too,I would refuse and get sent home instead. It was always very interesting. They had 5 beds in L&D and 2 ORs. If you needed another nurse the babies went out to mom and the nursery nurse came to help you. Now where I work there are 9 beds for L&D, 5 Triage beds that double as recovery, and 2 ORs. There is no floating but we are rarely ever slow and I work 12 hour shifts so rarely if ever the chance to leave early because it affects the next shift. Which is always short. Any way you would probably do better to concentrate on the computer and ldt the paper go. Goog luck :rolleyes: :balloons:

OMG!! We initially had to do both too. Some of us almost quit. The L&D unit that I work on is supposed to staff 6 or 7 on days, 5 on eve and 5 on nights. Well reality is 5 on days, 4 on eve and 3 on nights with people on call. It was almost impossible to do both. I thought it would be better just to scrap the paper and jump right into the computer. Then you had to learn it and didn' t have a net (of paper) so to speak. It is 6 months since going live and we have Dr. that refuse to use the computer to chart, nurses who use paper in triage because the triage in the computer is way to long, nurses who skip over parts of the admission or don't do the admission because they don't like it. I would have to say many of us only like the point and click part of the Fetal Heart Tracing. The rest is just a pain. I used to work at a little hospital like that. They would staff 3 nurses, one in PP, one in the nursery, one in L&D. You could get floated out too,I would refuse and get sent home instead. It was always very interesting. They had 5 beds in L&D and 2 ORs. If you needed another nurse the babies went out to mom and the nursery nurse came to help you. Now where I work there are 9 beds for L&D, 5 Triage beds that double as recovery, and 2 ORs. There is no floating but we are rarely ever slow and I work 12 hour shifts so rarely if ever the chance to leave early because it affects the next shift. Which is always short. Any way you would probably do better to concentrate on the computer and ldt the paper go. Goog luck :rolleyes: :balloons:

We have wathchild for L/D. I like it. We have meditech for postpartum, GYN, nursery and I can't say the same for it. I really hate meditech. I just don't find it to be user friendly. It is slow. The screens are tedious. It is often out of service. We've had it for 2 years or so and there have been some provements made. We were originally told that watchild (which we've had for 5 years) would be able to communicate w/ meditech. That has not proven true at our facility. Consequently, much of the info. we ask for watchild on admission is asked again for meditech PP.

We have wathchild for L/D. I like it. We have meditech for postpartum, GYN, nursery and I can't say the same for it. I really hate meditech. I just don't find it to be user friendly. It is slow. The screens are tedious. It is often out of service. We've had it for 2 years or so and there have been some provements made. We were originally told that watchild (which we've had for 5 years) would be able to communicate w/ meditech. That has not proven true at our facility. Consequently, much of the info. we ask for watchild on admission is asked again for meditech PP.

With the QS system we do not, and I repeat, do not do the admission in meditech. Only in QS. Our managers are great to back us up on this, esp. when the rest of the hospital is using meditech.(only l/d,level 1,ante and pp are using QS) Occasionally we have some one going from ante to the OR or our OR to ICU We then print up all our admission screens and let them figure out what to do with meditech. We only use meditech for orders at this point and allerigies,ht and wt for the pharm.

With the QS system we do not, and I repeat, do not do the admission in meditech. Only in QS. Our managers are great to back us up on this, esp. when the rest of the hospital is using meditech.(only l/d,level 1,ante and pp are using QS) Occasionally we have some one going from ante to the OR or our OR to ICU We then print up all our admission screens and let them figure out what to do with meditech. We only use meditech for orders at this point and allerigies,ht and wt for the pharm.

tntrn, ASN, RN

Specializes in L & D; Postpartum. Has 34 years experience.

Our unit is being staffed to the bare bones now. Last week, I had 5 rooms, 2 were first day post c/s mother-baby units, plus 3 p/o gyns. Two of those were fresh, one of which came back during report. Needless to say, I didn't get my initial assessments done until almost 5:30 and my charge nurse, bless her heart passed the prns. This was a very heavy load, but they're nickle and diming us to the max. It will take a seriously disastrous negative outcome to correct this I fear.

For our labor patients we have managed to keep 1:1 if they are active. Pre-term stuff is 2:1, but even that can be very iffey depending on just how stable they are and what kind of pre-term thing we are dealing with.

We have Watchchild. I do not like it. I can't imagine like any kind of totally paperless charting. I really like being able to take my paper fetal monitor strip and do the charting from that, especially after one of "those" deliveries. You know the ones. I'll be dipped in you-know-what if I'm going to ignore my patient to satisfy a computer. At this point we mostly do only the admission using WC, and with any luck at all, I'll be retired before they go totally off the deep end.

IMHO, computer charting leaves far less time for actual patient care and especially interaction. There's no real way to have a face-to-face admission interview when your face is staring at a computer monitor screen. And some of our nurses do the admission forms from the prenatal records at the nursing station, so even less patient contact when that happens. I've started printing off a blank admission section (the one with about 100 questions) and doing a sit-down interview, like the good old days. I can plug in the answers later. That really takes very little more time, and I feel like it more fully satisfies the idea of being available to our patients.

I do like having central monitoring which enables any of us to pop in and ask if another nurse needs help when we see something that might be a problem.

tntrn, ASN, RN

Specializes in L & D; Postpartum. Has 34 years experience.

Our unit is being staffed to the bare bones now. Last week, I had 5 rooms, 2 were first day post c/s mother-baby units, plus 3 p/o gyns. Two of those were fresh, one of which came back during report. Needless to say, I didn't get my initial assessments done until almost 5:30 and my charge nurse, bless her heart passed the prns. This was a very heavy load, but they're nickle and diming us to the max. It will take a seriously disastrous negative outcome to correct this I fear.

For our labor patients we have managed to keep 1:1 if they are active. Pre-term stuff is 2:1, but even that can be very iffey depending on just how stable they are and what kind of pre-term thing we are dealing with.

We have Watchchild. I do not like it. I can't imagine like any kind of totally paperless charting. I really like being able to take my paper fetal monitor strip and do the charting from that, especially after one of "those" deliveries. You know the ones. I'll be dipped in you-know-what if I'm going to ignore my patient to satisfy a computer. At this point we mostly do only the admission using WC, and with any luck at all, I'll be retired before they go totally off the deep end.

IMHO, computer charting leaves far less time for actual patient care and especially interaction. There's no real way to have a face-to-face admission interview when your face is staring at a computer monitor screen. And some of our nurses do the admission forms from the prenatal records at the nursing station, so even less patient contact when that happens. I've started printing off a blank admission section (the one with about 100 questions) and doing a sit-down interview, like the good old days. I can plug in the answers later. That really takes very little more time, and I feel like it more fully satisfies the idea of being available to our patients.

I do like having central monitoring which enables any of us to pop in and ask if another nurse needs help when we see something that might be a problem.

SmilingBluEyes

Has 26 years experience.

computer charting indeed gets in the way of my interaction with my patients. We are forever trying to figure this or that out, taking much more time to chart. It's a real pain and not saving us any time whatsoever. I strongly dislike it myself. The whole idea was to increase legibility and accountability, as well as save time. Hmmph, well 2 out of 3 aint bad, but tell that to my patients, who need me to teach em to breastfeed or other baby/self-care.

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