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.

[wooh, BSN, RN]

I've been through two different hospitals roll outs of computer charting (one with a very out of date system, one with a modern one), and it's all up to the staff to have a good attitude about it, IMO. When people are of the attitude, "It's going to make everything take longer, what about when it breaks down, I can't type fast enough..." then yes, it's going to be a slow process. If you insist on doing your charting on paper everytime and THEN putting it in the computer, yes it's going to take longer. But when nurses bite the bullet and actually learn to let the computer work for them, it will. BUT, it does take planning, it does take training, and it definitely takes making sure that you aren't charting things in 2/3/4 different places. (Of course, the double and triple charting happens on paper too, so that can't solely be blamed on the computers.)

[oramar]

I have an odd situation with this site in that it will not let me turn the page till the page is complete. I can see that there is a third page to this thread but I can not read it. Just want to give more information on article. The study was done in 2002. It ONLY shows that there is a problem during the INTRODUCTORY stage of new computer system when the users do NOT have proper training. It shows that these problems DO impact patient outcomes. Follow up studies show that once the users become comfortable with system patient outcomes improve. I say that this spike in mortality is NOT acceptable and changes have to be made in the way computer systems are initally introduced to keep this spike in mortality from occuring.

[MTBanRN]

I agree that when implementing a new system it is a must that all staff involved go through a dry run a few times in order to get the kinks out. This should be the normal practice of hospitals based upon the fact that care is of the utmost importance. Never been in such situations at any of my hospitals but it would be a scary one if I had.

[SFCardiacRN]

Computers are increasing the quality of care for patients. Once you learn the system, you'll never want to go back. Some people will always resist change even when it is for the best. There is ALWAYS a back up for when computers are down. IMHO

[SmilingBluEyes]

Depends on the program. We have meditech and it's the most dangerous system I have even seen, particularly the E-MAR portion. If you are not EXTREMELY careful, it does not document meds given. It's slow, DOS-driven and is a real waste of money, resources and time.

I am all pro-technology, believe me. But not when it's 20-odd years old. It's holding US BACK then and it becomes DANGEROUS when it's not working right.

[sunnybrook83]

The facility I work at has meditech also. I work PACU and do not have experience with E-mar, however, we have glitches in the program that are so frustrating- screens freezing and not allowing you to access the interventions you want to document on. They've had meditech for 10-15 years now. We are building a new hospital- I asked them if we're getting a new charting system as well (realizing that when they purchased it, options were limited)..... No answer. There has to be a better program out there that doesn't require 9 different screens to document a basic PACU admission assessment.

[barefootlady, ADN, RN]

Many, many shift I feel more like a secretary than a nurse. Now, I know a good secretary is worth their weight in gold, but so is a good nurse. You remember when a nurse could actually be at the bedside? Those were the days!!!!

[ShayRN]

Many, many shift I feel more like a secretary than a nurse. Now, I know a good secretary is worth their weight in gold, but so is a good nurse. You remember when a nurse could actually be at the bedside? Those were the days!!!!

I must respectfully disagree. I spend a lot of time with my patients and less than half the time I use to spend charting. Maybe we just have a really good program?

[SmilingBluEyes]

you must. Ours takes more time then paper and pen ever did.

[perfectbluebuildings, BSN, RN]

We have Meditech also, but our MARs we still sign off by hand. It has a tendency to freeze up a lot during off shifts or run slowly, and I swear there have been times I've charted on a kid and later gone back and nothing I charted for a certain time is in the computer... I do kind of like computer charting, but then as a nurse that's all I've ever used. It seems efficient to me most of the time, but I don't know if maybe it's a newer version than some other places? I can type a lot faster than I can write too which helps. I don't know how long this hospital has had computer charting though. Good training seems like it's essential... and kind of obviously essential... but I guess it's harder to plan things like this than I'd know.

[SmilingBluEyes]

Pray EMAR does not come online for you, Rae.

[perfectbluebuildings, BSN, RN]

Pray EMAR does not come online for you, Rae.

I do, I do! I can't imagine the nightmare of documenting meds on computer. We've had handwritten MARs till about a month ago. How long have you all been doing computer charting?