Is this charting on unresponsive patients ethical?

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Dear Beth,

The small company I worked for sold to a publicly traded health care company in July 2021. We switched to an EMR which requires false information be entered in order to advance the program (one example: entering a value using the Edmonton Symptom Assessment System when patient is unresponsive).

My narrative note is in conflict with what is documented in the program. I have done limited research into EMR and obstacles faced by nurses. Would you please offer perspective. This is the second EMR program I have worked with. I did not have a moral/ethical/legal conflict with the first program. Are these common concerns, among nurses, regarding the EMR?

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3 Answers

Make a dot phrase that says "Disregard Edmonton Symptom Assessment System score. Entry is required and has been made solely for EMR functionality."

Use it whenever appropriate.

Specializes in Psych, Addictions, SOL (Student of Life).

Also each question in the ESAS has a zero score which I  assume can be used for unresponsive patients. 

1 hour ago, hppygr8ful said:

Also each question in the ESAS has a zero score which I  assume can be used for unresponsive patients. 

I admit not having had to use this scoring, so have a question: Since this is supposed to be a patient generated score (much like the 0-10 pain scale is) wouldn't doing that ^ be like just putting "0" for the pain scale, as if the patient had actually answered "0", when in fact they did not answer at all because they are unconscious and so some other form of rating would have been more appropriate?

2 hours ago, JKL33 said:

I admit not having had to use this scoring, so have a question: Since this is supposed to be a patient generated score (much like the 0-10 pain scale is) wouldn't doing that ^ be like just putting "0" for the pain scale, as if the patient had actually answered "0", when in fact they did not answer at all because they are unconscious and so some other form of rating would have been more appropriate?

It is, and in my opinion it originated with someone in a non-clinical role.

On 11/15/2022 at 8:59 PM, Nurse Beth said:

... We switched to an EMR which requires false information be entered in order to advance the program (one example: entering a value using the Edmonton Symptom Assessment System when patient is unresponsive).

[...]

Based on my experience when we rolled out Epic, my suspicion here would be that they were told this by someone from the EMR rollout team that this had to be completed and it was never questioned.  Regardless, it's ridiculous that they are being made to do this.

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