disturbing article in Wall Street Journal

[oramar]

Sorry, do not have a link. Wall Street Journal does not give links easily to articles because as far as they are concerned it is money out of there pocket. However, this info should be available in other journals before to long and link will be avaliable there. I will give you a brief summary of what this article says. UPMC Childrens Hospital introduced a new computer system recently and while it was introducing this computer system it commissioned a study on the effects of this new system on the patients. God help us all the death rate of children shot up. The study directly related the increase in deaths to nurses and doctors being bogged down in a unfamiliar computer system while patient critical needs were not being met. Now most of here have been though new computer systems and most of us had a gut feeling that the situation adversely affected patients outcomes but now there is proof that it does. I have an opinion why this is happening but it is just that my opinion. Most institutions have a superuser system for introducing new technology. They give intensive training to a small number of people who are supposed to spread the knowledge around. The rest of the staff gets minimal training and are supposed to rely on the superusers for the bulk of there training. In my opinion this system is bad and I think this study proves that it kills. All staff need to recieve the same same training as the superusers because anything less is deadly.

[RosesrReder, BSN, MSN, RN]

wow, I agree that all staff needs the same exact training. It should be mandatory and paid for as well.

[DusktilDawn]

I worked at one place where 1 year before a computerized system was introduced, staff had mandatory training for 4 hours. Number one, training a year prior is pointless, you forget too much of what was taught.

The problem when a lot of this new technology is implemented, staff are usually trained "on the job," so to speak. This is where you can have a situation where patient needs are not met. There is certainly a better way to train staff in regards to this matter that does not place patients in danger. Training for a new computer system should not be done OTJ, it is takes valuable time away from patients when it is done this way. Usually staff are not relieved from duty when they are taught a new system.

They give intensive training to a small number of people who are supposed to spread the knowledge around. The rest of the staff gets minimal training and are supposed to rely on the superusers for the bulk of there training. In my opinion this system is bad and I think this study proves that it kills. All staff need to recieve the same same training as the superusers because anything less is deadly.

True, that is how they usually do it, train a small number of people and they are supposed to act as a resource for the rest of the staff. The amount of these "resource" people on off shifts is even smaller or next to no one being available. The people also used for "resource" are usually proficient in regards to computers to start with prior to training. When implementing a new computer system, it should be done almost like a computer course, with assignments and tests, and longer than a few hours, in essence it should be similiar to how it is done in college/university computer courses IMO. It should not be done while you are trying to take care of patients.

[Cienna2000]

I'm not a nurse or even a nursing student yet (but I want to be). My drive to become a nurse comes from my daughter's 47 day stay in the NICU. (I am waiting until she is a little older before I go back to school, I normally just lurk here to get a idea of what to expect in the future)

During her stay our hospital implemented a new computer system with charting (they were paper charting only at her admission and conitnued to paper chart as back up during the rest of her stay). I know that I personally complained to the NM, DON and the CEO of the hospital over the computerized charting. My daughter was still critical as were other babies and the staff nurses were so busy trying to figure out the computers that they were pretty much ignoring the babies. The only good nurses the preemies had during this time were the travelers (since they had used computerized charting elsewhere it didn't bother them).

From what I observed I think that hospital staff (even the doctors were having problems) should recieve indepth PAID training for a new computer system so that they can still take care of their patients during a change over such as this. My husband is a computer geek and he was helping the head of the NICU with a computer problem that the Help(less) Desk said did not exist.

[oramar]

Last Friday evening I found myself trying to put critical lab test into a computer with no superuser in the building. We had to call someone at home and have them talk us through it. People's life hang in the balance when they are septic or have meningitis. You just can't be playing around in these situations. I think the situation that Cienna is describing happens somewhere every day in this country and it is just not acceptable. It is the fault of managment types who do NOT want to pay to have people properly trained.

[RosesrReder, BSN, MSN, RN]

Seems like more patients need to die, for them to finally realize the importance of fresh, pain and equal traininng with a superuser in the building readily available. Sad

[JaneyW]

I think there should also be alternate ways to order labs and process MD orders while there is a new system being learned. I went through this at my last place and I feel it did compromise patient care. The lab refused to process the stat order until it was totally correct in the system or they would see something different on their screen than we were. The pharmacist can't fill a stat order until the allergies were entered correctly even though they had a verbal from the RN or MD, etc. All of these situations are unacceptable and should be anticipated.

[Marie_LPN, RN, LPN, RN]

I think since our computerized system was introduced in our dept. the pt. receives less attention. Half the time on the computer is trying to get it to WORK.

[lee1]

Oramar,

Can you remember the title of the article??? We are going though a new computer system roll out and it is VERY PAINFUL right now. It would certainly be nice to have this article to show as evidence based reasons for why system roll outs are failing

[RosesrReder, BSN, MSN, RN]

I think since our computerized system was introduced in our dept. the pt. receives less attention. Half the time on the computer is trying to get it to WORK.

oh wow

[llg, PhD, RN]

Thanks for passing along the information. I'll be watching for more on it.

As some of you know, my doctoral dissertation was on the subject of information technology and nursing. I took the stand that we need to be careful about simply accepting what "the computer people" tell us and question a lot of things about increasing computerization. Taking that stand, unpopular at the time, meant the end of my chances for a career specializing in nursing and technology. I poked holes in more than a few sacred cows in the nursing informatics field. It was too "politically incorrect."

I guess I was just ahead of my time.

I have very mixed feelings reading this latest finding. Of course, I hate to see that any patient have suffered. A little part of me feels vindicated that some of my insights have shown themselves to have been right all along. Yet, I also feel sadness about "what might have been" had I been able to make myself heard back then.

llg

[purplemania, BSN, RN]

I don't think you should state the statistic was due to only a few being educated to the computer until you know the facts. It could be the statistic was interpreted incorrectly.