CPOE computer physician order entry

nurse2033, MSN, RN · Feb 9, 2011

That sounds ridiculous and completely removes the benefit of CPOE. CPOE reduces medical errors because it removes one step in the transcription process. You can bet, if you are a professional order entry RN and the MD makes a bad order, you are going to get blamed. We use this system and it works great once the MDs get used to it.

MunoRN, RN · Feb 9, 2011

There are legal requirements for CPOE that are being phased in over the next few years and it doesn't allow for orders to be entered by someone else; the orders must be entered directly by the ordering physician. The whole point of the requirement is to limit errors that occur between a verbal order or handwritten order and the order actually being entered, so an MD having someone who enters their verbal or written orders would be no different than the system we have now.

kmenningen · Feb 9, 2011

This is a system that the hospital I work at just transitioned to and it is a big adjustment. It would be frowned upon to have a nurse putting in all the orders. Once a doctor know the system and work orders and flows, they do pretty well with it.

Have you thought about work in informatics? Many nurses are needed to implement this and are hired for managing and evaluating this type of medical software.

Kirsten

iluvivt, BSN, RN · Feb 9, 2011

Yes same thing happened where I work..a lot of them complained...BUT NOW..they love it and have the hang of it. It actually saves them a lot of time as they can place their orders remotely if need be It is also much faster than actually hand writing them all out. The MDs can set up their favorites and a lot of the orders related to a specific care area are grouped into plans. So with a click of the mouse a list of orders comes up. A nurse,of course can still take a verbal order. I know of one MD that has a vision problem and he has permission form administration to hand write his orders and a nurse has to input them. The system will not work if the nurses have to put all the orders in and that also takes away the safety components as others have described.

Bezoars · Feb 9, 2011

I have been an advocate of this CPOE for a long time... seems common sense to me, in this age of computers... nobody likes change but nobody likes being blamed for others' mistakes either... this keeps the drs accountable.

Up2nogood RN, RN · Feb 9, 2011

I really don't think an organization would allow a physician to hire a freelance nurse to enter his orders. I know mine wouldn't. That would be totally contrary to what CPOE is all about. Plus you'll have floor nurses ready to tear your head off for going against what we have been striving for many years. CPOE is almost the best thing since sliced bread I say.

KeyMaster · Feb 9, 2011

CPOE is only as good as the leadership enforcing the edict. In my hospitals the MDs who don't want to enter their own orders simply find a workaround. They will not hire their own order scribes when they can simply have the floor nurse do it anyway. It has become a rather tiresome game. The nurses are not able to enter verbal orders, but they can enter telephone orders. So doc sits down at the nurses station and calls the desk. The nurse sitting next to him answers the phone...ta da...phone orders. Yes, we have an MD that actually does this.

Leadership was concerned that the MDs wouldn't be able to deliver timely care until they learned and were comfortable with CPOE...so we instituted paper "e-orders" for the nurse or secretary to transcribe IF the MD was concerned that he might not be able to enter a critical order correctly. We were going to have them as a bridge for two, maybe four weeks. Of course ALL orders were critical orders to several MDs, so ALL orders became e-orders. Oh, we started that two years ago. We still currently have e-orders, but hear they may be going away soon....

APRN., DNP, RN, APRN, NP · Feb 9, 2011

The facility where I work utilizes CPOE. What a joke. Without the backing of administration to force MD's to input their own orders, all CPOE created was more work for the RN's who had to learn how to do the MD's job's and input the orders because the MD's weren't at a computer, or were driving, or too laz...*ahem* busy to input their own orders.

TDCHIM · Feb 9, 2011

The facility where I work utilizes CPOE. What a joke. Without the backing of administration to force MD's to input their own orders, all CPOE created was more work for the RN's who had to learn how to do the MD's job's and input the orders because the MD's weren't at a computer, or were driving, or too laz...*ahem* busy to input their own orders.

AGREED. New technology has to be put into place with real, meaningful backing from management or it's going to fail miserably. There is always going to be resistance of some sort to change, but that resistance can only be overcome if management (at all levels) enforces the change and doesn't let anyone wiggle out of complying with the new system/rules/order.

RNperdiem, RN · Feb 9, 2011

The residents where I work earn less than the nurses, I doubt anyone is going to hire a nurse for orders.

Where I work, the doctors go on rounds with a computer on wheels and plan their day, and an intern or resident puts the orders in the computer right there and then.

Up2nogood RN, RN · Feb 10, 2011

AGREED. New technology has to be put into place with real, meaningful backing from management or it's going to fail miserably. There is always going to be resistance of some sort to change, but that resistance can only be overcome if management (at all levels) enforces the change and doesn't let anyone wiggle out of complying with the new system/rules/order.

There is only one group of docs in my hospital that WON'T enter their own orders, the orthopods. Which is beyond me what their excuse may be as they've been practicing physicians in this hospital for many years. I am clueless how management lets them get away with this. It's a good thing I don't have to work on that floor:)