Computerized charting

Veteran Nurse · Dec 8, 2005

I work in ER. We use Cerner hospital wide. The system is integrated to include radiology, lab, etc... I find it to be user friendly, except for the slow downs. The system is unavailable 2-3 times a week for system problems. We use a paper system during this time. This is very irritating to me. The rollout was 2 years ago. It seems to me that would be enough time to work out the "bugs". :confused:

veegeern, BSN, RN · Dec 8, 2005

We use "meditech" in our hospital. The hardware differs by unit...On the med/surg floors each nurse has a large metal medicine cart that team's meds and general supplies. A laptop is mounted to the cart that is wirelessly connected to the system and can do everything but print. We also have computer terminals at the desk...these are connected to the printer. We scan medications and patient armbands in our faciltity for the MAR, so we also have a scanner connected to the laptop.

We chart on computerized flow sheets. We type nurse's notes in a screen not unlike this one. Some nurses take the lap top to the room and enter the admission info right into the flow sheet. I find this distracting, so I still use a print out of a blank flow sheet to make notes, and then go to the nurse's stattion to enter it into the computer. On a good day it takes about 20-30 minutes from entering the info to printing and placing on chart if I'm not interrupted.

lee1 · Dec 10, 2005

I work in ER. We use Cerner hospital wide. The system is integrated to include radiology, lab, etc... I find it to be user friendly, except for the slow downs. The system is unavailable 2-3 times a week for system problems. We use a paper system during this time. This is very irritating to me. The rollout was 2 years ago. It seems to me that would be enough time to work out the "bugs".

Who has to enter the downtime information????

veegeern, BSN, RN · Dec 11, 2005

Who has to enter the downtime information????

We either bring in extra nurses to enter info, or our nurse manager enters it for us. In 2 years, we've only had 2 downtimes. They were scheduled, and each lasted less than 12 hours.

PamRNC · Dec 11, 2005

We use Eclipsys for our RN and ancillary documentation, labs are imported to it from the Cerner system, Physician order entry is in it and communicates to other departments including Pharmacy, lab, radiology, etc. The system is great for paperless charting, and we have access to old charts from previous admits in the system, which means if the nsg hx was completed on the last admit it can be copied and then updated for the current admit. We can also print specific notes or sections as needed. The docs should be charting in Eclipsys, but only a few services are. There is still a paper chart for that and some really ancient paper flow sheets we had to use during an unanticipated downtime.

The charting follows the idea of the sections in a paper chart. For instance under the tab flowsheets you have: Vital Signs, I&O, Respiratory, Neuro, Treatments, Patient Education, and a couple of others. Each flowsheet can be modified for your patients' needs, either by adding or removing individual parameters or by using a macro. The macros are templates which place parameters on each of the relevant flowsheets without having to go back and forth from sheet to sheet. So for a med/surg admit with a few keystrokes you could set up the flowsheets to include fingersticks, POx, foley output, peripheral IV, safety and braden risk assessments, etc. The care plan is comprised of including standards of care or protocols on the assessment flowsheet, and in one section of the flowsheet we detail the plan of care for that shift. Most of the charting can be done by selecting items from drop down lists and clicking on it. If those things don't apply then you can type in what you want. The items in the system get updated on a regular basis, and for progress notes there are templates for some of the more common notes. The only problem is there doesn't seem to be any way for me as a staff nurse to have input into some of the changes going into the system. For instance I think there should be a template for a blood transfusion note to make them more uniform - we got pegged by CMMS on a visit recently for discrepancies on blood transfusion notes.

From what I understand Eclipsys is based on an older computer system called UNIX. My floor has about 20 computers around the entire unit (and somedays it still doesn't seem like enough). Most of the computers are at stationary, there are a few on carts throughout the unit, but only one has a wireless connection to the system and the battery which should make it a mobile unit has been long since fried. The oncology unit does have computers built onto their medication carts (I wonder if they'd notice if I traded one of theirs for one of ours?).