For those of you who use computer charting....

[deespoohbear]

I was wondering how many of you use computer charting (bedside nursing in a M/S unit in particular) and what your opinion of it is. What system do you use? Do you like it? If so, why? If no, why not? Our facility is looking to build a new facility in a couple of years and we are trying to decide on a program for computer charting. Any infor would be helfpful Thanks.

[bellehill, RN]

We started computer charting about 1 month ago and I have mixed feelings about it. It is nice to have everything in the computer, easily accessible my doctor and nurse and readable. I think that a lot of charting gets missed. It takes on average 10 minutes to chart an assessment, if you have no interruptions. If you have an interruption and need to leave the computer you must log-off before you leave the terminal. So in order to start charting again you must log back on the computer. It is a pain.

We use laptops on carts that roll around the floor but can't stay in the hall (fire hazard). The powers that be want us to take the computers in the room and chart during our assessment. We don't want to take the computers in the rooms and expose all the patients to each others germs. Plus I would rather see the patient when I assess, not a computer screen.

Our system is Mednet, it is a good system I think, we don't have too many problems with it. As you can see I have mixed feelings about computer charting. It is easier to write it down and I think it was more accurate.

Sorry my thoughts are jumbled...I just got up and I had a bad night last night with the computers. They aren't the worst thing to happen to us but I don't think they are the best either.

[st4304]

Have used Care Manager for two years now. Just recently went to 'charting by exception' and has saved us tons of time.

Only cons about it, for me, are I sometimes feel like I am not charting enough AND sometimes I have to fight the respiratory therapists for the computer (I work in open heart and each room has a computer that we share with respiratory -- if they are in there weaning or making vent changes, so am I. Soooooo, we arm wrestle for it. And since I am a weenie, I always lose. lol)

I find that you either love it or hate it.

[deespoohbear]

Our manager really wants us to do bedside charting. I feel like this would be quicker (and more secure) if we had a laptop in every room. We still use regular charts and so we are looking for a new charting system for the new hospital. Since most of us at our facility don't have any experience with computer charting we are asking friends who work at other hospitals what computer charting they use. Thanks for the replies.

[SheilaK]

Have been doing electronic charting for about a year, maybe a little longer with the VA, we are usig CPRS - I forget what it stands for, something about computerized personal records..

It has it's ups and its downs. The best thing I like about it is there is no more guessing about a dotor's order. All orders have to be put in via the computer - I can actually read everything without feeling like I am decifering code. We have templates, point and click on alot of the stuff we have to do, like fall risk, elopement risk and initial and complete assessments. Care plans were just added about 2 weeks ago. Things don't always work as plans, computer glitches, you you still have to double check everything.

What i dislike about it, you can't edit a note after you have signed it, you have to make an addemdum (sp) to the note. That ans some days I feel like nothing more than a glorified computer tech. But comp tech's make a lot more $$ than I do.

[jode]

We use Care Manager (COW). Very mixed feelings about this. I do a fair amount of retrospective chart review,and I find it difficult to locate the information I need. I think charting by exception would be more beneficial for this program, but all I can ever think is that there must be a better way..........especially when the system goes down.........

[night owl]

We also use CPRS at our VA, (Computerized Patient Record System) and have been for about three years now. I love it and would not go back to paper charting...ONLY when the computer is down . I love how you can click on something say the cover sheet to find info you need for a note and then click back to your note and continue to type away. That addendum thing stinks...I agree and I wish they could let us edit notes. But for the most part, I think it's a better system, and I'm happy with it. :)

We also have the portable workstation (Computer on wheels) that you can take to the bedside. We'll use this sometimes when something is wrong with the computer on our med carts to scan those barcodes...ugh, or the Doctor uses it on her/his rounds for orders.

[HazeK]

DON'T use Meditech.....not user-friendly at all!

DO use a nurse-friendly system your facillity can customize and adapt!

It is worth every extra penny!

(I use a system in L&D called QMI that is user-friendly, with forms all designed by OUR nurses and translated to the computer!)

[Nurse Ratched, RN]

I have used Care Manager and Invision. I enjoy using computers and find that both packages were pretty easy to pick up on. As HazeK said, make sure your IT people can tweak the system to meet your needs. And there have to be plenty of workstations, both stationary and portable, to meet everyone's needs. Laptops must be nailed down as they WILL walk off.

We are supposed to be going to the docs doing computer orders soon - cam't wait until I don't have to scratch my head over their heiroglyphics anymore. The docs have been the most resistant to the switchover to computers.

[st4304]

Originally posted by SheilaK

What i dislike about it, you can't edit a note after you have signed it, you have to make an addemdum (sp) to the note. That ans some days I feel like nothing more than a glorified computer tech. But comp tech's make a lot more $$ than I do.

With Care Manager, we can edit and move. It just notes in the review display that 'this charting has been edited' and at what time and by whom. At the bottom of every screen are boxes that you can free text to add notes in your own words. We are constantly 'tweeking' Care Manager and it is very user friendly.

deespoohbear -- you are in Indiana aren't you? If you are ever near or in Columbus, IN, let me know and I can arrange for you to check out our computer charting. They also use Care Manager at St. Francis Hosp in Indy.

[deespoohbear]

Yep, I am in Indiana!! Up near Ft. Wayne. If I ever make it down toward Columbus I will be sure to let you know. We won't be going to computers for at least 2 years until the new hospital is built. But we are looking into for ideas. I really appreciate everyone's input on these-both pro and con. I plan to take the ideas to my manager next week.

[NRSKarenRN, BSN, RN]

You could PM rninformatics. Angela is our BB expert on these matters.

Posting info she sent me after my agency considering systems. I joined the nursing mail list and it has been helpful in understanding differing types of systems

Per Angela:

I'd suggest posting your questions to nursingL The listserve includes nurses and others involved in informatics, and healthcare IS/IT and is hosted by AMIA (the American Medical Informatics Association :

nrsing-l maillist - [email protected]

http://mailman.amia.org/mailman/listinfo/nrsing-l

MANI -The Midwest Alliance for Nursing Informatics

http://www.maninet.org

ANIA- The American Nursing Informatics Assoc

http://www.ania.org

HIMSS- Health Information Systems Society

http://www.himss.org

Happy hunting. We are at the inplimentation phase. Up and running for one month now and reaching "tweaking phase" so we can generate first bill with new system.