Electronic charting vs. Hourly Rounding vs. Bedside Charting

[AngeliqueR]

At our hospital we have many competitors for nurse's time: electronic charting (Allscripts Sunrise Clinical Manager with "KBC" nursing documents) and hourly rounding. We also purchased new WOW's with the expectation that nurses would start charting at the bedside but it has not happened.

Do you do hourly rounding or bedside charting at your hospital? If so, does your electronic documentation make it easier or more difficult to accomplish these things?

[calivianya, BSN, RN]

The hospital I just finished working at did all three. There was a computer in every room, so it was very easy to chart in the room, but there were also hourly rounding sheets on the bathroom doors to sign. It wasn't bad, and honestly the more I charted in the room the quicker I'd be out the door that night. It seems like it saves time to do things in the room, write them down or just remember, and come back to chart them later, but it really doesn't. Taking that extra step and spending a couple minutes longer in the room to chart saves you a lot more time than you would ever believe!

[CodeteamB]

What is the rationale for bedside charting?

[Tait, MSN, RN]

What is the rationale for bedside charting?

Less opportunity for errors and incongruence in charting if you write it down while it is fresh. Also getting it done right away means more time for other tasks and less time staying after to chart.

[RNperdiem, RN]

My hospital does all of the above.

In ICU, we are frequently in patient rooms, so hourly rounding doesn't really change anything.

I could fill in a paper chart in less than 5 minutes. Personally, I find electronic charting takes more time to do all the clicking and passwords required to complete and assessment. Not to mention the times when the software is running slow or the computers on wheels are off the unit for repair. If you could track where a nurse's eyes go these days, you would probably find a nurse spends more time looking at a screen than at the patient.

Charting at the bedside works well only if the patient is not trying to engage you in conversation and there are no visitors present. I keep losing my train of thought if I have to talk and chart at the same time.

Charting at the computers in the nursing station has its own set of distractions, so I chart wherever is least distracting.

[classicdame, MSN, EdD]

another rationale for bedside charting is that others who need to see the chart can do so electronically and get real-time information. I do diabetic teaching and have to run down the nurses to find out what the latest glucose result was, or how long they have been NPO or other stuff. Respiratory and other disciplines need that data as well. I worked where we did all three and you can get in a groove and get it all down faster. When I was out of the last room I was DONE

[silverbells_star]

We have computers in all the rooms, but I don't like to do bedside charting because I feel like I'm only looking at the computer and am ignoring the patient. I rarely stay past my shift, so for me it's not a time issue to do it in the room or an hour later at the nurses station. But there are some nurses on my floor that just sit at the nurses station and gossip so for them I could see that it would save time to chart in the room, they are constantly staying late because they just "can't seem to find the time" to get everything done.

[HyperSaurus, RN, BSN]

I have recently gotten into the habit of bedside charting--or at least the relevant parts of their assessment. I've found that it's easier for me to be accurate and I finish charting much sooner than if I wait until I have time to sit.