Published Feb 6, 2003
Our hospital is about to install computers for the nurses on the units....would like to hear any and all feedback on the use of computers for charting, ordeering, test results, etc. What do you think of it? What do you like or dislike..we are attempting to "be one step ahead" of the complaints prior to installatiion..Any comments would be greatly appreciated!
I work in ICU and we use the CareVue system for charting. It charts our vitals which default in from the bedside monitor(HP's). We chart our assessments, medications, etc. There is NO manual documentation for nurses at my facility. Even the floors are using computer charting now and from what I hear they LOVE it. Everyone complains when the electricity goes off and we have to revert back to the flowsheets.
Well.........maybe it's just our certain system but it seems like with the computer charting you are just documenting the same thing over and over, just in different areas of the "chart". For example:
Under "urinary" I document that, but then the SAME info goes under "I & O" and under "patient tubing" (for Foley cath), and also in my "Patient notes"!
Same goes for vital and virtually all systems assessments! It just gets to be MORE time consuming!
AND, when I was admitting a patient (we have a computer in each patient room) I was to the END of a 7 page admission assessment and history form when the screen went "BLANK" and all my info was gone!
I told someone to get me a piece of paper and a pencil!!!!! This was at 2 a.m. and the patient had to answer some of the same questions again, (what I could not remember, such as phone numbers and certain patient stats)!
PLUS, if you have a LARGE patient load, MAKE SURE that you are in the correct screen. MANY times a nurse documents for 15 minutes on each line item, and then when she/he glances up, she finds that the info is in the wrong chart. She has to UNDO and then REDO!!!!
The usefulness depends completely on the software being used and the training that healthcare workers receive. Some programs and systems are much better than others.
Thanks for the feedback...have you noted one software to be "more user friendly" than others? I will be doing the training in nursing service and appreciate your assistance. When is someone going to ask the nurse what is needed in the software?
llg, PhD, RN
All the companies claim that they are "nurse friendly," but there is a lot of difference between having nurses on the design/training teams and really designing the systems from a nursing perspective.
For example, I just reviewed a system that was TOTALLY based on the medical problem list. There wasn't even a place to list nursing problems. All of the different professions were supposed to list all of their problems in the same place. Now ... how many physicians do you know who wouldn't make a fuss about every other discipline's problems intermingling with their own?
Another issue I have run into (did a paper on it in grad school, actually) ... Some companies equate "nursing time at the bedside" with "the delivery of good nursing care." That is how they justify putting the terminals at the bedside. However, having the nurse tapping away at the computer a few feet away from the pt's bed does NOT promote rest. It also does not promote privacy for the patient and family. It certainly does not equate with "giving good patient care" in many situations.
You have to be careful about stuff like that. Many times, nurses are "being sold a bill of goods" when a system is purchased. Sometimes, the companies act like old-fashioned snake-oil salesmen and it can lead to disaster. Too often, the system is chosen because the doctors like it, or the finance guys like it, or something. The nurses just agree to it because they think any computer is better than nothing. As a profession, we need to be assertive in the design and purchase of systems.
altomga, ADN, BSN, MSN, DNP, RN, APRN
I would have to agree that computer charting depends on the software your hospital chooses. I have done computer charting for 5yrs and wouldn't trade it for anything. Yes, some of it is repetitive, but we send this info on to IS to see if they will change it. Also if there is something you want added you can request it to the hospital IS department. We actually have different software for ordering tests, equipment, etc, one for nurses to chart, another just for the doctors to review labs and test results. The ER have their own system also. It sucks at first b/c you aren't used to it, but once you learn where everything is you can chart fairly quickly. We may get carpal tunnel, but no more writers cramp!!!! LOL
ruralok writes: "When is someone going to ask the nurse what is needed in the software?"
You have an interesting sense of humor.
Why else do you think there are usually so many problems when facilities convert to computers? The people making the decisions are NOT the people who actually use these systems. Not to mention the characteristically inadequate "training" that endusers receive.
Time to talk with your union, IMHO, and get in on the decisions. This will affect you all, significantly. NOBODY is going to ask, you are going to have to demand, if you want to have any influence in this matter, (as in most matters).
I certainly agree....that is why I am asking for direction, so I will be knowledgable and have some creditabilty when I do confront "the establishment" with questions and requests...Your insight and comments are greatly appreciated...
BadBird, BSN, RN
I love computer charting, I was resistant at first but when I started to use it and discovered how easy and quick it was I dread going to a unit that doesn't have a computer charting system.
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