Kardexes and Care Plans in current use

[eecRN]

Has anyone had any trouble with Kardexes and Care Plans used in the workplace? I'm currently trying to come up with a solution to continuity in care. I had an incident at work in which I recieved a horrible report from the previous shift. When I went to assess the patient and received abnormal labs on the patient at the same time the on-call doc happened to be walking by. He jumped in on the situation but I was left scrambling trying to figure out what had happened in the last four days that the patient had been there and giving the on-call doc sketchy at best details of the patients history and current situation. What is the solution? Does anyone work in a hospital that utilizes really great care plans that are passed between shifts or have great Kardexes that really keep everyone in the know? Let me know what your experiences have been.

Thanks

[Cheyenne RN,BSHS]

has anyone had any trouble with kardexes and care plans used in the workplace? i'm currently trying to come up with a solution to continuity in care. i had an incident at work in which i recieved a horrible report from the previous shift. when i went to assess the patient and received abnormal labs on the patient at the same time the on-call doc happened to be walking by. he jumped in on the situation but i was left scrambling trying to figure out what had happened in the last four days that the patient had been there and giving the on-call doc sketchy at best details of the patients history and current situation. what is the solution? does anyone work in a hospital that utilizes really great care plans that are passed between shifts or have great kardexes that really keep everyone in the know? let me know what your experiences have been.

thanks

our facility uses the computerized charting system and our kardexes are printed out at the beginning of the shift. the care plans are built into the plan of care on admission and may change based on the shift to shift nursing assessment.

we give verbal report at shift change on only the patients we are specifically assigned and no one else. there may be thirty patients on the floor, but i will only hear about my own specific patients from the nurse directly involved in their care.

even with all this, the report given is only as good and detailed as the nurse giving it. i have some days that i wouldn't know who has a foley and who does not, when their iv's were last started or what abnormal labs exist.

when i have a nurse who wants to basically just say "well you got six patients on a hall and last time i saw them they were all breathing, then it up to me to know what questions to ask to obtain the information that i need.

if i have been off a few days and will have a new group of patients, i deliberately come to work early so that i can review each of my patients labs and any tests or procedures. i also read over the history and physical that the doctor has done and i then put notes on my assignment sheet that i carry.

it takes about 15 minutes for me to review everyones information, but then i am as prepared as i can be for taking care of all my patients and sort of know what has happened to them since admission and what their test results are.

[psalm_55]

Does anyone really use care plans?

have to agree with above. the kardexes and info are only as good as the person(s) passing it along.

i like to do my own review of chart, etc.

when i was in ICU, we had a clipboard for each patient that had columns for various info such as lung sounds, heart sounds, labs, VS, etc. it was just a worksheet that each nurse used. and we left at least past two days of info on clipboard. these did not go in the chart, were pitched when appropriate.