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.

[Judee Smudee, ADN, 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

My hubby reads the Wall Street Journal so I went looking for it in todays issue. It is on page D6. It is called "Tech Glitches Can Slow Patient Care." Sub titled, New Computers May Deliver Turmoil When They Arrive, One Study Cites Death Rates. You are not the only one having trouble getting though to them IIg, the article states, "Officials at Children's Hospital disagree with their own researchers".

[Judee Smudee, ADN, 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.

I reread the original post and I do believe the original poster qualifies his statement by saying "this is just my opinion" and then repeats it is his opinion.

[llg, PhD, RN]

My hubby reads the Wall Street Journal so I went looking for it in todays issue. It is on page D6. It is called "Tech Glitches Can Slow Patient Care." Sub titled, New Computers May Deliver Turmoil When They Arrive, One Study Cites Death Rates. You are not the only one having trouble getting though to them IIg, the article states, "Officials at Children's Hospital disagree with their own researchers".

People who are "sold" on a technology just don't want to listen to anyone who advocates caution. They have "technology goggles" on -- the equivalent of the "beer goggles" that some people wear when they have had too much to drink.

Granted, there is usually room for interpretation in any research study -- and the computer changes may have played only a small part (if any) in the specific deaths mentioned in the article. However, the anectodal evidence is overwhelming: these roll outs never go as smoothly and painlessly as the salespeople say they will. Also, the systems are never as perfect as the salespeople claim that they are. I've been around to long to believe the hype.

Fortunately, the hospital I work for now seems to have a very sensible philosophy about such things -- and is SLOWLY moving toward increased computerization, etc., allowing the systems to mature and many of the bugs to be worked out before investing.

Unfortunately, many young nurses mistakenly believe that only those hospitals that are on the "cutting edge" of computerization are good hospitals. They think that there must be something wrong with a hospital that still has not completely computerized its documentation systems. They don't realize that the slower approach may, in fact, be the wiser one.

llg

[Marie_LPN, RN, LPN, RN]

How many pts. would you say that are sold on the "cutting edge" technology? If they weren't hospitals wouldn't be advertising it on the radio.

[suzanne4, RN]

I love computer based charting and have used it in the OR, as well as ICUs. The issue sounds more like the IT dept that is doing the training. If the system is working properly, then it should actually save you time.

But to put a nurse in a room with a patient on the table in the OR, that is not already literate with the system is just not acceptable, and I have seen that happen. I have seen systems that have worked beautifully and have integrated quite well, and I have seen others that have totally bombed.

The best success stories, that I have seen, have come from facilities that only brought one unit up at a time, like a pilot program, and worked the glitches out from there first. Then as things progressed, and any quirks fixed, the system rolled out to more areas.

There should be a super user on each shift and each unit, especially in the beginning of a roll-out and this should be a nurse, not an IT person. Sure, the IT people are great, but at this point, you need the input from a nurse.

The above is strictly my opinion only, and from my experiences firsthand.

[hipab4hands]

Our department totally relies on the computer. Unfortunatetly, the powers that be insisted on using 20 year old computer programs and technology, rather than an updated system. As a result, when they try to update the computer programs, the system will constantly crash for several days.

This slows down our ability to respond to patient needs, because we have t go back to pen and paper. In addition, once the computer is back up, we have to re-enter, everything that was done with paper and pen system.

We do get training to use these "updated" system, but like everyone else has pointed out, this happens 4-6 months before the system goes into effect. By the time, the new update is up and running, you've forgotten the training you recieved.

[1Tulip]

This is a tale of two hospitals.

In our town, there are two main med centers. One of them decided a couple of years ago to leap into the 21st Century and computerize everything. For reasons already well stated here, it's been a huge mess. As a result, doctors are admitting pts to the other hospital which is bursting at the seams. The 21st C place is like a tomb, maybe two or three pts per unit. Hemorrhaging money, laying off nurses. Do you think the suits would go for a "do-over", maybe retrace their steps and rethink this? Absolutely not. They act as if their best hope for salvation is to get more stream-lined and modern.

It's pathetic.

Hope the other place is paying attention, so that if/when they go computerized, they'll do it better.

[whiskeygirl, LPN]

llg, I was considering a similar stand on cumputers and nursing. I would love to read your dissertation.

[ShayRN]

My hosptial has been computorized for over 3 years. I would have to see the study, I am one of those who believe that you can make statistic say whatever you want them to say. Computors have been WONDERFUL for us, saves tons of time. Once a patient has been to the hospital, a P&A is in the system forever. It literally takes me less than 10 minutes to do admission papers. I can look up old charts in the computor and charting is done in half the time when done PROPERLY.

[DusktilDawn]

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.

I encountered similar problems in regards to other departments and implementing a new computer system. The kicker was that there usually was someone IN THEIR department that could have corrected it, but there seems to sometimes be an attitude of "stick it to nurses" whenever possible, because the bottom line is we will be held accountable for things not done, not them. Had a similar situation with lab, first day, new system. There was a glitch and the computer kept entering the order for the next day, despite repeated calls lab refused to do a patient's blood work, it was not the person entering the order who was at fault, it was a problem with the program.

I'm not against computers per se. What I'm against is staff learning on the job at the expense of the patients.

[tattooednurse]

were you talking about children's hospital of Pittsburgh?

I started my career there using cerner. The hospital gives kyou a six hour class on it before you get to the unit. Then I had a four month orientation on the the floor which was policy for the PICU so evryone understood the computer pretty good as long as the took the time to listen and learn. While I was there One of the PICU attendings actually wrote and published data that so that Cerner actually raised the survivors rate in the PICU.

Don't get me wrong it has been about 1 1/2 years since I have been there so the data could have changed(unfortunately)

[nursemaa]

I would have to ask how soon after implementation was the study done, and also look at other factors at the time the study was done. Statistics are often used to "prove" things, yet you can manipulate them to prove just about anything you want. I always read research studies with a skeptical mind, because so often another study comes along that "proves" just the opposite of the first one! It would be interesting to read the actual research article, not just the media's representation of it.