Scanning in the supply room

[elizabeast7, ADN, BSN, MSN]

Greetings!

Our hospital has supply rooms set up for each unit with a scanning system. We are routinely not scanning, and thus not charging for supplies.

Hypothetically, staff will sign into the computer, select the patient, scan the item, hit save and log out of their ID.

This is not happening.

Any suggestions? How does your facility track supplies?

[Okami_CCRN, BSN, RN]

We do not track supplies, patients are charged a flat rate for supplies and it covers everything from syringes to alcohol swabs to socks.

If patients receive an invasive procedure such as a central line insertion then they are charged individually for the catheter kit.

[elizabeast7, ADN, BSN, MSN]

Yes - that is how we are, too. Things are grouped in two categories.

Non-scan - syringes, toiletries, etc.

Scanned - wound care, foleys, IV tubing, etc.

We are not scanning those items, though! Secondary tubing and blood tubing are the ones we scan the least - and thus are losing money on. We lost >$25,000 in 2015 r/t to this so I thought I'd see if anyone has advice.

Unfortunately, it's difficult to make staff accountable as we have no way of monitoring who is not scanning what. Supposedly, staff signs in and thus we can track that way but more often staff simply doesn't - or they scan the item using the account that's up on the monitor and so a few people look like they've scanned all the items.

[Rose_Queen, BSN, MSN, RN]

I think it's sad the focus is on charging and not patient care. Nurses don't have the time for all these extra steps to do something as simple as hanging an antibiotic or a vasoactive drip.

[elizabeast7, ADN, BSN, MSN]

Who said the focus isn't on patient care? I am a nurse on this unit, and I do the same thing - fail to scan items. But I know that I, and many of my peers, don't scan even when we aren't in a hurry. There are many non-STAT items we are not scanning. The whole process adds less than a minute or two to the administration or skill. Additionally, nurses - and this is what I try to do - could keep track of what they're using and then go back later and scan it.

Furthermore, the financial loss to the unit means that we wasted that amount instead of purchasing new equipment, additional COWs/glucometers, etc.

[dishes, BSN, RN]

Have you asked the staff their reasons for not scanning? Have you listened to their answers with an open mind?

[Rose_Queen, BSN, MSN, RN]

Who said the focus isn't on patient care?

That wasn't directed at you, but was a statement about healthcare in general.

Seems health care in general is a business- catering to "customers", worrying about the bottom line. Heck, we recently got an email where I work about emergency medications that weren't scanned into the EMR (were documented on paper that was then scanned into the EMR but doesn't transfer into the medication record). Was the focus that it wasn't documented in the MAR? No, the focus was the fact that the facility missed out on about $7,000 of income and the calculations of exactly how much each med cost, how much would have been charged to each patient, and the total the facility didn't get reimbursed.

[Penelope_Pitstop, BSN, RN]

I would probably get canned if I had to do this. I was taught to be an anticipator (I guess that isn't a word - oh well), especially when setting up a room prior to an admission. I'd rather never use that bedpan than not have one available when I need it. So I'd either scan for tons of things that ended up not being necessary or scan for everything and never leave the supply room because I was still scanning stuff...

[elizabeast7, ADN, BSN, MSN]

Have you asked the staff their reasons for not scanning? Have you listened to their answers with an open mind?

Most of their answers are similar to mine. I am a staff nurse - we were discussing this in our last staff meeting so I thought I'd post and see what other facilities do.

Rose Queen - I agree. Health care is now considered a "customer service industry" by many. However, in this instance, the problem stems from money. We are a very small hospital in a rural area. Our budget is constantly being lowered and when losses like these - preventable losses - are present then it's difficult to get anything new approved. We need new vital sign machines, beds with alarms, computers, etc. If we can't get new equipment then patient care is affected.

[BittyBabyGrower, MSN, RN]

We scan items at the bedside, we are usually signed in there to check orders and such. Can you do that?

[elizabeast7, ADN, BSN, MSN]

That's an interesting thought. We are actually beginning a process to develop a new charting system. Currently, the system we use for the supply room and the charting system are totally different but I wonder if they could be integrated? I'll bring it up at the next meeting. Thank you!!

[Julesmama28]

Our expensive items are usually in the Omnicell, and therefore the patient gets charged when we pull it out under their name.