Going Back to Paper

Are you working in LTC? That is the only place where I have recently come across paper charting. It seemed they had paper charting everywhere!!! Things were not centralized like in acute care. Most LTC facilities are going to PCC(Point Click Care) because they are going to have to link up with EMR from the local hospitals etc. Try to centralize as much of the documentation as you can. I always felt like I was going to miss something because there were "parts of the chart" spread in various binders etc. I would pull all of my patients chart forms and have them with me throughout the day, the MARs the coumadin sheets, the I & O sheets, wound sheets etc. I kept them in my own binder for the day and returned them to their proper place at the end of my shift. That way I kept everything I needed for the day together and it kept me from missing documentation. Good Luck!!

It is a LTC facility and they are preparing to transfer to PCC. They've already switched over a little but I believe it is only notes and care plans. That is a great idea about the charting pages, of course I'll be the only nurse on the unit during my shifts. Maybe that will help reduce some of the old stress of hunting out charts / parts of charts. I remember doing that and don't miss it.